(Lift  i-  B.  Hill  ffiibrarg 

Nnrtli  (Earoltna  ^tnXt 
Inttipraitg 


111 


C 


This  book  was  presented  by 

MILTON  M.  LEONARD,  D.V.M. 

TO  THE 

VETERINARY  MEDICAL  LIBRARY 


This  book  is  due  on  the  date  indicated 
below  and  is  subject  to  an  overdue 
fine  as  posted  at  the  circulation  desk. 


EXCEPTION:  Date  due  will  be 
earlier  if  this  item  is  RECALLED. 


APR  2  9  2002 


.^  j?  J*  ** 


DISEASES    OF    CATTLE,    SHEEP,    GOATS, 
AND    SWINE. 


BY   THE    SAME    AUTHOR. 


lloiinl  S/v,,  4:^S  //./,/....,  4()(;   Uliistrathni^. 

A  Handbook  of  Horse-shoeing. 

With  Introductoiy  Chai)ters  on  the  Anatomy  and  Physiology 
of  the  Horse's  Foot.  The  section  on  the  "  Practice  of  Shoe- 
ing" contains  'A  full-))age  plates"  and  descriptive  notes 
supplied  by  Albeht  Wheatley,  F.R.C.V.S. 


t;()  Idifjo  jUKjcx  (14.1  X  10   'inchet!).  31,">  llli/xfnifi 
An  Atlas  of  Veterinary  Surgical  Operations. 


A  Surgical  Operating  Table  for  the  Horse. 


ll,il/t/I  Sn,.  f)lS  jwf/rx.  [K,   i/Ii/stn/fiottx. 
Studies  in  Clinical  Veterinary  Medicine  and  Surgery. 
By  r.  J.  C'ADioT  and  ,ixo.  A.  W.   Dollar. 


I?in//il  Sn*.  2(i'.t  yv///r.s-.   272  ill >(.■<( nttionx. 
The  Practice  of  Veterinary  Surgery. 

Vol.  I.— Opehative  Techxique. 


Ihyildl  8n(.  ,S.")3  pagrx.  31,")   IHiixfnif/d/i.t. 
The  Practice  of  Veterinary  Surgery. 

By  H.  MoLl;EK  and  Jno.  A.  W.   DoLLAU. 

Vol.    III. — liEGIONAL    SUKGEKY. 


DISEASES  OF 

CATTLE,  SHEEP,  GOATS 
AND  SWINE 


By 


G.  MOUSSU 

PROFESSOR  AT  THE  VETERINARY  COLLEGE  OF  ALPORT;  DOCTOR 
OF  MEDICINE;  DOCTOR  OF  SCIENCE,  ETC. 


JNO.  A.  W.  DOLLAR,  M.  R.  C  V.  S.,  F.  R.  S.  E.,  M.  R.  L 

PRESIDENT    OF    THE    ROYAL    COLLEGE    OF    VETERINARY     SURGEONS;     VICE- 
PRESIDENT    OF    THE    ROYAL    INSTITUTE    OF    PUBLIC    HEALTH;    CORRE- 
SPONDING   MEMBER    OF    THE    CENTRAL    SOCIETY    OF    VETERINARY 
MEDICINE  OF  PARIS;  ASSOCIATE  OF  THE  SOCIETY  OF  VETER- 
INARY   MEDICINE    OF    BRABANT    (BELGIUM);    LIFE    MEM- 
BER OF  ROYAL  ITALIAN  SOCIETY  OF  HYGIENE,  ETC. 


AMERICAN  VETERINARY  PUBLISHING  COMPANY 
CHICAGO 
PUBLISHER 
1920 

(All  Rights   Reserved) 


PEEFACE 


No  apology  seems  called  for  in  presenting  to  English -speaking 
veterinary  surgeons  and  students  a  treatise  on  the  diseases  of  cattle. 
To  those  entrusted  with  the  onerous  task  of  preventing  or  curing  disease 
in  cattle,  sheep,  and  swine  the  scantiness  of  permanent  literature  dealing 
with  the  subject  must  always  have  proved  a  matter  of  some  embarrass- 
ment, while  to  teachers  and  students  alike  the  want  of  a  concise  and 
modern  text-book  has  long  been  a  difficulty  of  the  first  order.  It  is 
hoped  that  the  present  volume  may  go  some  way  towards  remedying 
this  state  of  affairs. 

As  on  previous  occasions,  the  writer  has  freely  availed  himself  of 
foreign  sources  of  information.  Two  years  ago  he  purchased  the 
literary  rights  in  Professor  Moussu's  "  Maladies  du  Betail,"  which 
had  even  then  attained  an  European  reputation,  and  which  forms  the 
backbone  of  the  present  volume.  To  obtain  further  information,  the 
more  important  German  treatises  have  been  laid  under  contribution, 
while  all  accessible  English,  American,  and  Colonial  literature  of  recent 
date  has  been  referred  to.  (The  references  practically  extend  up  to 
the  moment  of  writing — the  latest  being  June,  1905.)  In  this  way 
the  work  may  in  some  degree  claim  to  have  assumed  an  international 
character.  The  extent  of  the  additions  is  indicated  by  an  increase  in 
the  number  of  illustrations  of  140,  and  of  the  text  of  nearly  50  per  cent. 

Professor  McQueen  has  performed  the  greatly- valued  service  of 
reading  j)roof-sheets  and  advising  the  writer  as  the  book  passed 
through  the  press. 

To  Dr.  Salmon,  of  the  United  States  Department  of  Agriculture, 
special  thanks  are  due  for  his  generous  permission  to  quote  from  the 
annual  reports  of  that  body. 

Other  acknowledgments  will  be  found  in  the  text. 


PREFACE. 


Once  again  the  writer,  who  on  this  occasion  chances  also  to  be  the 
President  of  the  Eoyal  College  of  Veterinary  Surgeons,  appeals  for 
lenient  judgment  on  work  performed  under  no  common  stress  of  duties, 
professional  and  political. 

JNO.   A.  W.   DOLLAR. 

56,  New  Bond  Street, 

London,  England, 

June,  1905. 


CONTENTS 


SECTION  I. 

DISEASES   OF    THE    OEGANS   OF   LOCOMOTION. 

CHAP.  PAGE 

Methods  op  Examination 1 

I.     DISEASES   OF   BONES 3 

General  Diseases .  4 

Eachitis 4 

Osseous  Cachexia 7 

Local  Affections 20 

Fractures 20 

Fractures  of  the  horns 21 

Detachment  of  the  horns       ........  23 

Fissuring  of  the  horns 24 

Fractures  of  the  horns           ....         ....  25 

Exostoses 27 

Spavin  in  the  ox. 27 

Eing-bone 28 

Suppurating  ostitis       .........  29 

Bone  tumours 30 

II.     DISEASES   OF   THE   FOOT 31 

Congestion  of  the  Chxws        ........  31 

Contusions  of  the  sole 31 

Laminitis      .         .         .         .         .         .         .         .         .         .         .32 

Sand  crack 34 

Pricks  and  stabs  in  shoeing  ........  36 

Picked-up  nails,  etc.  ("  Gathered  nail") 37 

Inflammation  of  the  interdigital  space  (Condj'lomata)  ...  38 

Canker 40 

Grease           ...........  41 

Panaritium — Felon — Whitlow 41 

Foot  rot        ...........  43 

III.     DISEASES    OF   THE    SYNOVIAL   MEMBEANES   AND   OF    THE 

AETICULATIONS 45 

I.  Synovial  Membranes  and  Articulations        ....  45 

Synovitis 45 

Inflammation  of  the  patellar  synovial  capsule       .         ,         ,         ,  45 


CONTENTS. 


CHAP. 
III.     DISEASES   OF    THE  SYNOVIAL    MEMBRANES  AND   OF  THE 
ARTICULATIONS— coj/<//<  ueiL 
I.  Synovial  Membranes  and  KKncvLX-vios^a— continued. 
Distension  of  the  synovial  capsule  of  the  hock  joint 
Distension  of  tendon  sheaths  in  the  hock  region 
Distension  of  the  synovial  capsule  of  the  knee  joint 
Distension  of  the  synovial  capsule  of  the  fetlock  joint 
Distension  of  tendon  sheaths 

Distension  of  tendon  sheaths  in  the  region  of  the  knee 
Distension  of  the  bursal  sheath  of  the  flexor  tendons 
Traumatic  synovitis—"  Open  synovitis" 
Traumatic  tendinous  synovitis 
Traumatic   articular   synovitis  —  Traumatic   arthritis —"  Open 
arthritis" 


III. 


IV 


IV 


ir.  Strains  of  Joints  .... 
Strain  of  the  shoulder  .... 
Strain  of  the  knee 

Strain  of  the  fetlock      .... 
Strain  of  the  stifle  joint 
Strain  of  the  hock  joint 
Luxation  of  Joints 
Luxation  of  the  femur 
Luxation  of  the  patella 
Luxation  of  the  femoro-tibial  articulation 
Luxation  of  the  scapulo-hiimeral  joint 

IIVGKOMAS 

Hygroma  of  the  knee    .... 

Hj'groma  of  the  haunch 

Hygroma  of  the  trochanter  of  the  femur 

Hygroma  of  the  stifle 

Hygroma  of  the  point  of  the  hock 

Hygroma  of  the  point  of  the  sternum  . 

DISEASES   OF   MUSCLES   AND   TENDONS 

Rupture  of  (he  external  ischio-tibial  muscle 
Rupture  of  the  flexor  metatarsi     . 

Parasitic  Diseases  of  Muscles     . 
Cysticercus  disease  of  the  pig 


Beef  measles 
Trichiniasis — Trichinosis 


RHEUMATISM 

Articular  iheumatism 
Muscular  rheumatism 

Infectious  Forms  of  Rheumatism  ok  Pseudo-riieum 
Infectious  rheumatism  in  young  animals 
Infectious  pseudo-rheumatism  in  adults 
Scurvv — Scorbutus       ,,.... 


(Biceps  femoi 


.CONTENTS. 


SECTION  II. 

DISEASES  OF  THE  DIGESTIVE  APPAEATUS. 

CHAP.  PAGE 

Semiology  of  xni-:  Digestive  Apparatus 106 

I.     DISEASES  OF  THE  MOUTH 121 

Stomatitis 121 

Simple  stomatitis   .         .         .         .         .         .         .         .         .121 

Catiirrhal  stomatitis  in  sheep  ......     122 

Necrosing  stomatitis  in  calves 123 

Mycotic  stomatitis  in  calves  .......     12-1 

Ulcerative  stomatitis  in  sheep        .         .         .         .         .         .125 

General  catarrhal  stomatitis  in  swine 126 

Ulcerative  stomatitis  in  swine        .         .         .         .         ,         .127 

Mercnrial  stomatitis       .         .         .         .         .         .         .         .128 

Glossitis        ...........     130 

Superficial  glossitis        .         .         .         .         .         .         .         .130 

Acute  deep-seated  glossitis  ...         .         .         .         .         .131 

Chronic  glossitis     .         .         .         .         .         .         .         .         .132 

II.  DISEASES     OF     THE     SALIVAEY     GLANDS,     TONSILS     AND 

PHAEYNX 134 

Parotiditis  (Parotitis) 134 

Acute  parotiditis    .         .         .         .         .         .         .         .         .     1 34 

Chronic  parotiditis— Parotid  fistula        .         .         .         .         .136 

Inflammation  of  the  submaxillarj^  salivary  gland  .         .         .137 

Tonsilitis  in  pigs  ..........     138 

Pharyngitis 138 

Pseudo-membranous  pharyngitis  in  cattle     .         .         .         .     141 

Pseudo-membranous  pharyngitis  in  sheep     ....     142 

Pharyngeal  polypi         .         .         .         .         .         .         .         .         .143 

III.  DISEASES  OF  THE   (ESOPHAGUS 145 

CEsophagitis  ..........     145 

Stricture  of  the  oesophagus  ........     148 

Dilatation  of  the  a'sophagus  .         .         .         .         .         .  .149 

Oesophageal  obstructions      .         .         .  .         .         .         .         .152 

Euptures  and  perforations  of  the  oesojihagus         .         .         .         .157 

IV.  DEPEAVED  APPETITE— THE  LICKING  HABIT— INDIGESTION     158 

Depraved  ajipetite  in  the  ox 158 

Depraved  appetite  in  calves  and  lambs  .....     160 

Colic  in  the  ox 162 

Colic  due  to  ingestion  of  cold  water — Congestive  colic  .         .     162 
Colic  due  to  invagination        .         .         .         .         .         .         .163 

Colic  as  a  result  of  strangiUation    .         .         .         .         .         .167 

Diseases  of  the  stomach 169 

Indigestion 170 

Gaseous  indigestion       .         .         .         .         .      .  j         .         :     17Q 


X  CONTENTS, 

CHAP.  PAGE 

IV.     DErHAVED  APPETITE— THE  LICKIXG  HABIT— INDIGESTIOX 
— continued. 

Indigestion — c(,i,tliiiiril. 

Impaction  of  the  rumen — Indigestion  as  a  result  of  over- 
eating          175 

Impaction  of  the  omasum  (third  stomach)      .         .         .         .179 

Abomasal  indigestion     .  .         .         .         .         .         .         .182 

Acute  gastiic  indigestion  in  swine  .         .         .         .         .185 

Y.     INFLAMMATION   OF  THE   GASTEIC   COMPARTMENTS     .         .186 

Eumenitis—Eeticulitis— Gastritis 180 

Acute  gastritis ISS 

Catarrhal  gastritis  in  swine    .         .         .         .         .         .         .190 

Ulcerative  gasti'itis        ........     191 

Chronic  tymj^anites         .         .         .         .         .         .         .         .194 

Gastric  disturbance  due  to  foreign  bodies       .         .         .         .198 

Tumours  of  the  gastric  compartments 202 

VI.     ENTERITIS 203 

Acute  enteritis 203 

Heemorrhagic  enteritis  ........     206 

Chronic  enteritis  (Chronic  diarrhrea)     ......     207 

Dysentery  in  calves       .         .         .         .         .         .         .         .         .210 

Diarrhoeic  enteritis  in  calves 212 

VII.     POISONING 215 

Poisoning  due  to  food 215 

Poisoning  by  caustic  alkalies        .         .         .         .         .         .         .216 

Poisoning  by  caustic  acids    .         .         .         .         .         .         .         .217 

Poisoning  by  common  salt    .         .         .         .         .         .         .         .217 

Poisoning  by  the  nitrates  of  potash  and  soda         .         .         .         .217 

Poisoning  by  tartar  emetic 218 

Poisoning  by  arsenic     .         .         .         .         .         .         .  .         .218 

Phosphorus  poisoning  .         .         .  .         .         .         .         .         .219 

Mercurial  poisoning      .........     219 

Lead  poisoning :  Saturnism  ........     220 

Coj^per  poisoning 221 

Carbolic  acid  poisoning 221 

Poisoning  by  aloes        .         .         .         .         .         .         .         .         .221 

Iodoform  poisoning 222 

Iodine  poisoning :  iodism 222 

Strychnine  poisoning    .........     222 

List  of  plants  poisonous  to  stock 223 

Colchicum  poisoning 256 

Poisoning  bj'  auniial  mercury       .......     256 

Poisoning  by  bryony    .........     256 

Poisoning  by  castor  oil  cake 257 

Poisoning  by  cotton  cake      ........     257 

Poisoning  by  molasses  refuse 258 

Diseases  produced  by  distillery  and  sugar  factory  i)ulp         .         .     259 

VIII.     PARASITES  OF   THE  DIGESTIVE  APPARATUS  ....     263 
Gastro-intestinal  strongylosis  in  sheep  .....     263 

IjumbricGsis  of  calyes  .         ,         .         ,         .         ,         ,         ,         ,267 


CONTENTS.  Xi 

CHAP.  P^(.g 

VIII.     PARASITES   OF   THE   DIGESTIVE   AVFAUAT\JS~conti»,re,l. 

Strongylosis  of  the  abomasum  in  the  ox       ....         .  268 

Parasitic  gastro-enteritis,  diarrhoea,  and  anremia  in  cattle,  sheep 

and  lambs          ..........  268 

Intestinal  coccidiosis  of  calves  and  lambs  (Psorospermosis,  hremor- 
rhagic  enteritis,  bloodj'  flux,  dysentery,  etc.)     .         .         .         .271 

Intestinal  helminthiasis  in  ruminants  ......  275 

IX.     DISEASES   OF   THE   LIVER 279 

Congestion  of  the  liver 280 

Nodular  necrosing  hepatitis 280 

Cancer  of  the  liver  and  bile  ducts 282 

Echinococcosis  of  the  liver 283 

Suppurative  echinococcosis   ........  288 

Cysticercosis .         .         .  290 

Distomatosis — Liver  fluke  disease— Liver  rot       ....  293 

SECTION   III. 

EESPIKATOEY  APPAEATUS. 
I.     EXAMINATION  OF  THE  RESPIRATORY  APPARATUS      .         .311 

II.     NASAL   CAVITIES 319 

Simple  coryza        .         .         .         .         .         .         .         .         .         .  319 

Gangrenous  coryza        .........  320 

Tumours  of  the  nasal  cavities        .......  325 

Purulent  collections  in  the  nasal  sinuses.     Nasal  gleet         .         .  326 

Purulent  collections  in  the  frontal  sinus        .....  327 

Purulent  collections  in  the  maxillary  sinus  .....  329 

(Estrus  larvse  in  the  facial  sinuses  of  sheep 330 

III.  LARYNX,   TBACHEA  AND  BRONCHI 333 

Laryngitis 333 

Acute  laryngitis 333 

Pseudo-membranous  laryngitis      ......  333 

Tumours  of  the  larynx 335 

Bronchitis 336 

Simple  acute  bronchitis 337 

Chronic  bronchitis           ........  337 

Pseudo-membranous  bronchitis 339 

Verminous  bronchitis  in  sheep  and  cattle  (Husk,  hoose,  etc.)  340 

IV.  LUNGS  AND  PLEURA 343 

Pulmonary  congestion  .         .         .         .         .         .         .         .         .343 

Simple  pneumonia        .........  343 

Pneumonia  due  to  foreign  bodies — Mechanical  pneumonia  .         .  347 
Pneumonia  due  to  tlie  migration  of  foreign  bodies  from  the 

reticulum  ..........  348 

Pneumomycosis  due  to  Aspergilli 350 

Gangrenous  broncho-pneumonia  due  to  foreign  bodies          .         .  351 

Infectious  broncho-pneumonia 354 

Broncho-pneumonia  of  sucking  calves  ...,.,  356 


CONTENTS. 


CHAP. 

IV.     T.UNGS  AND   Tl.'EVRM—cojdinued. 


Sclero-  caseous  broncho -pneuinoi 
Pulmonaiy  emiihysema 
Diseases  of  the  pleura 

Acute  pleurisy 

Chronic  pleurisy    . 
Pneumo-thorax    . 
Hydro-pneumo-thorax  and  pyo-pneumo-thorax 


a  of  sheep  ....     358 

359 


361 
361 
362 
362 
366 


V.     DISEASES  OF  STRUCTUEES  ENCLOSED  WITHIN  THE  MEDI- 
ASTINUM       368 

Tumours  of  the  Mediastinum 369 


SECTION  IV. 

THE    OEGANS   OF    CIRCULATION. 

Semiology  of  the  Organs  of  Circulation 370 

I.     CAEDIAC  ANOMALIES 374 

Ectopia  of  the  heart 374 

II.     PERICARDITIS 375 

Exudative  pericarditis  due  to  foreign  bodies         ....  376 

Chronic  pericarditis 389 

Pseudo- pericarditis 390 

III.  ENDOCARDITIS 394 

IV.  DISEASES  OF  BLOOD-VESSELS 396 

Phlebitis 396 

Accidental  phlebitis 396 

Internal  infectious  phlebitis  (Utero-ovarian  phlebitis) .         .         .  398 

Umbilical  phlebitis  of  new-born  animals 399 

LTmbilical  phlebitis  or  omphalo-phlebitis      .         .         .         .         .402 

V.     DISEASES  OF  THE  BLOOD 406 

Septicaemia  of  new-born  animals 406 

Takosis:  a  contagious  disease  of  goats 412 

Blood-poisoning  (Malignant  oedema)  in  sheep  and  lambs  in  New 

Zealand 415 

Piroplasmosis        .         .         .         .         .         .         .         .         .         .416 

Bovine  piroplasmosis 416 

Bovine  piroplasmosis  in  France     ......  424 

Ovine  piroplasmosis       ........  425 

Diseases  produced  by  trypanosomata    .         .         .         .         .         .426 

Louping-ill 429 

Suggested  measures  for  prevention        .....  435 

Braxy            ...........  435 

Bilharziosis  in  cattle  and  sheep 439 

Jleat  stroke— Over-exertion          .,,....  442 


CONTENTS.  XIU 
CHAP.                                                                                                                                                                                   PAGE 

VI.     DISEASES  OF  THE  LYMPHATIC  SYSTEM 444 

The  lymphogenic  diathesis 448 

Caseous  lymphadenitis  of  the  sheep      ......  453 

Goitre  in  calves  and  lambs 453 

SECTION  V. 

NERVOUS  SYSTEM. 

Cerebral  congestion 456 

Meningitis    ...........  456 

Encephalitis           ..........  458 

Cerebral  Tumours 459 

Insolation      ...........  460 

Post-partum  paralysis — Milk  fever — Mammary  toxremia — Par- 
turient apoplexy — Dropping  after  calving         .         .         .         .461 

Coonurosis  (Gid,  sturdy,  turn-sick) 467 

"  Trembling,"  or  Lumbar  prurigo,  in  sheep          ....  475 

SECTION   VI. 

DISEASES   OF   THE    PERITONEUM  AND   ABDOMINAL 
CAVITY. 

L     PERITONITIS 478 

Acute  peritonitis  ..........  478 

Chronic  peritonitis         .         .         .         .         •         ■  .         .         .481 

Ascites ............  483 

Peritoneal  cysticercosis          ........  485 

II.     HERNIA 487 

Congenital  hernite         .........  487 

Perineal  hernia  of  young  pigs         ......  487 

Umbilical  hernia 488 

Acqiiired  hernite 489 

Hernia  of  the  rumen     .........  490 

Hernia  of  the  abomasum 493 

Hei^nia  of  the  intestine  .         .         .         .         .         .         .         .494 

Treatment  of  hernise     .........  495 

Diaphragmatic  hernia  .........  496 

Eventration 499 

Fistulse  of  the  digestive  apparatus 500 

SECTION   VII. 

GENITO-URINARY  REGIONS. 

Diseases  of  the  Urinary  Apparatus 502 

I.  POLYPI  OF  THE  GLANS  PENIS  AND  SHEATH   .    .    .506 

Inflammation  of  the  sheath 506 

Persistence  of  the  ui-achus     ........  508 


XIV  CONTENTS. 

CHAP.  PAGE 

II.     DISEASES   OP  THE   BLADDER 511 

Acute  cystitis        .         .         .         .         .         .         .         .         .         .511 

Chronic  cystitis 513 

Urinary  lithiasis.     Calculus  formation  .         .         .         .         .514 

Calculi  in  bovine  animals  .         .         .         .         .         .515 

Urinary  calculi  in  sheej) 518 

Paralysis  of  tlie  bladder         .         .         .  .         .         .         .         .519 

Eversion  of  the  bladder         .         .         .         .         .         .         .         .519 

Heematuria  ...........     520 

III.  DISEASES   OF  THE   KIDNEYS 527 

Congestion  of  the  kidneys     ........  527 

Acute  nephritis     .         .         .         .         .         .         .         .         .         .528 

Chronic  nephritis ..........  530 

Hydro-nephrosis 531 

Infectious  pj'elo-nephritis 533 

Suppurative  nephritis  and  perinephritis         .....  537 

The  kidney  worm  {Sclernstoma  pinguicola)  of  swine       .         .         .  p39 

IV.  GENITAL   APPARATUS *     .     542 

Vaginitis       ...........  543 

Acute  vaginitis 544 

Contagious  vaginitis       ........  545 

Croupal  vaginitis   .........  545 

Chronic  vaginitis  .         .         .         .         .         .         .         .         .5-16 

Metritis 547 

Sejjtic  metritis        .         .         .         .         .         .  .         .         .547 

Acute  metritis        .........  550 

Chronic  metritis     .........  552 

Epizootic  abortion  in  cows    ........  553 

Salpingitis — Salpingo-ovaritis ooo 

Torsion  of  the  uterus    .........  556 

Tumours  of  the  uterus 559 

Tumours  of  the  ovary 559 

Genital  malformations 560 

Imperforate  vagina 560 

Nympho-mania    ..........  562 

V.     DISEASES   OF  THE   MAMMARY   GLANDS 565 

Physiological  anomalies        ........     567 

Wounds  or  traumatic  lesions         .......     568 

Chaps  and  cracks  .........     568 

Milkfistuloe 569 

Inflammatory  diseases 570 

Congestion  of  the  udder 570 

Mammitis      .         .         .  .         .         .         .         .         .         .  .571 

Acute  mammitis    .........     573 

Contagious  mammitis  in  milch  cows      .....     580 

Chronic  mammitis  .         .         .         .         .         .         .         .581 

Gangrenous  mammitis  of  milch  ewes     .....     583 

Gangrenous  mammitis  in  goats 584 


CONTENTS.  XV 

Chap.  pagr 

V.     DISEASES   OF   THE   MAMMARY  GLANDS— c<)»////»«/. 

Cysts  of  the  udder 585 

Tumours  of  the  udder  ......•••  585 

Verrucous  papillomata  of  the  udder      ......  586 

VI.     DISTURBANCE   IN  THE    MILK    SECRETION  AND    CHANGES 

IN   THE   MILK 587 

Microbic  changes  in  milk.      Lactic  ferments         ....  588 

VII.     MALE   GENITAL   ORGANS 594 

Tumours  of  the  testicle         .....•••  594 

Accessory  gknds  of  the  genital  apparatus 597 


SECTION    YIII. 

DISEASES   OF   THE    SKIN   AND   SUBCUTANEOUS 
CONNECTIVE    TISSUE. 

L     ECZEMA        , 599 

Acute  eczema        ........••  599 

Chronic  eczema 600 

Sebaceous  or  seborrhoeic  eczema 601 

Eczema  due  to  feeding  with  potato  pulp       .....  603 

Impetigo  in  the  pig       .........  605 

Acne  in  sheep        ..........  606 

Fagopyrisni  (Buckwheat  poisoning)      ......  608 

II.     PHTHIRIASIS 60S 

Scabies— Scab— Mange .        •        .611 

Scabies  in  sheep    .         .         .         .         .         .         .         •         •         .611 

Sarcoj^tic  scabies    .........  612 

Psoroptic  mange — Sheep  scab 614 

The  tobacco  and  sulphur  dip 626 

Lime  and  sulphur  dips 627 

Arsenical  dips          ........  632 

Carbcdic  dips  .........  633 

Chorioptic  mange — Symbiotic  mange — Foot  scab  .  '       .         .  636 

Mange  in  the  ox  .........         .  638 

Sarcoptic  mange     .........  638 

Psoroptic  mange    .........  639 

Chorioptic  mange 640 

Mange  in  the  goat 641 

Sarcoptic  mange    .         .         .         .         .         .         .         .         .641 

Chorioptic  mange  .........  642 

Mange  in  the  pig .         .         .         .         .         .         .          .         .         .  -642 

Demodecic  mange  .         .  .         .         .         .         .  .         .643 

Demodecic  nnnge  in  the  ox  .         .         .         .         .          .         .  644 

Demodecic  mange  in  the  goat         ......  644 

Demodecic  mange  in  the  pig .......  644 

Non-psoroptic  forms  of  acariasis 645 

Hypodermosis  in  the  ox  (warbles) 64^^ 


CONTENTS. 


CHAP. 

III.     EINGWORM 


Eingworin  in  the  sheep,  goat,  and  pij 
IV.     WARTS   IN  OXEN       .... 


Urticaria  in  the  pig 
Scleroderma 

V.     SUBCUTANEOUS   EMPHYSEMA 


rxr.ti 
649 
()J3 
055 
G5() 
657 

659 


SECTION    IX. 
DISEASES   OF   THE    EYES. 

Foreign  bodies      .         .         .         .         .         .         .         .         .         .6(51 

Conjunctivitis  and  keratitis 662 

Verminous  conjunctivitis 662 

Verminous  ophthalmia  of  the  ox  .         .         .  .         .         .         .     (Hi.'i 


land; 


md 


SECTION    X. 

INFECTIOUS   DISEASES. 

Cow-pox — Vaccinia 

Cow-pox  and  human  variola — Preparation  of  vacc 

Tetanus 

Actinomycosis        .                   ... 
Actinomycosis  of  the  maxilla 
Actinomycosis  of  the  tongue  . 
Actinomycosis  of  the  pharynx,  parotid 
Tuberculosis 

Tuberculosis  of  the  respiratory  apparatus 

Tuberculosis  of  the  serous  membranes 

Tuberculosis  of  lymphatic  glands  . 

Tuberculosis  of  the  digestive  tract 

Tuberculosis  of  the  genital  organs 

Tuberculosis  of  bones  and  articulations 

Tuberculosis  of  the  brain 

Tuberculosis  of  the  skin 

Acute  tuberculosis — Tuberculous  septicaemia 
Swine  fever — Verrucous  endocarditis  and  pneumonia  of  the 

Swine  fever    ...... 

Verrucous  endocarditis  of  the  pig  . 

Pneumonia  of  the  pig    ... 
Htemorrhagic  septictemia  in  cattle 


neck 


669 
67U 
672 
67;} 
674 
675 
6S2 
690 
694 
696 
699 
700 
701 
702 
703 
7C4 
710 
710 
7i;3 
714 
716 


SECTION    XL 

OPERATIONS. 

I.     CONTROL   OF   ANIMALS 720 

Control  of  oxen 720 

Partial  control        .         .         .         .         .         .         .         .         .720 

Control  of  the  limbs        .         .         .         .  .  .         .  .720 


CONTENTS. 


I.     CONTROL    OF   .XNIUAIuS— continued. 
Control  of  oxen — continued. 

General  control 

Control  by  casting 
Control  of  sheep  and  goats    . 
Control  of  pigs      .... 
Anaesthesia  ..... 

II.     CIRCULATORY  APPARATUS     . 
Bleeding       .... 
Bleeding  in  sheep  . 
Bleeding  in  the  pig 
Setons,  rowels,  plugs,  or  issues    . 

III.  APPARATUS   OF  LOCOMOTION 

Surgical  dressing  for  a  claw  .... 

Amputation  of  the  claw  or  of  the  two  last  phalanges 

IV.  DIGESTIVE  APPARATUS 

Ringing  pigs         .... 
oesophagus 

Passing  the  probang 

Crushing  foreign  bodies  in  the  a3sophagi 

ffisophagotomy 

Sub-mucous  dissection  of  the  foreign  body 
Rumen  ...... 

Puncture  of  the  rumen  . 
Gastrotomy  ...... 

Laparotomy 

Hernise 

Inguinal  hernia  in  young  pigs 

Imperforate  anus   .... 

Prolapsus  and  inversion  of  the  rectum 

V.     RESPIRATORY   APPARATUS      . 

Trephining  the  facial  sinuses 
Trephining  the  horn  core 
Frontal  sinus  .... 

Maxillary  sinus      .... 

Tracheotomy         ..... 

VI.     GENITO-URINARY   ORGANS     . 

Ur.ethrotomj'  in  the  ox  .         .  . 

Ischial  urethrotomy 
Scrotal  urethrotomj' 

of  the  catheter  and  urethrotomy  in  the 
of  the  catheter  in  the  cow 
Castration  ..... 
Castration  of  the  bull  and  ram 
Bistournage  .... 
Martelage  .... 
Castration  by  clams 


CONTENTS. 


CHAP. 

VI.     GENITO-URINAEY   ORGANS— co/i^m»ed 

Castration — continued. 

Castration  by  torsion     . 
Casti'ation  with  the  actual  cauterj' 
Castration  by  the  elastic  ligature  . 
Castration  of  the  ram    . 
Castration  of  boars  and  young  pigs 
Castration  of  cryptorchids 
Female  genital  organs  . 
Castration  of  the  cow     . 
Castration  of  the  sow     . 

Suture  of  the  vuha       .... 

Trusses         

Section  of  the  sphincter  of  the  teat 

Dilatation  of  the  orifice  of  tlie  teat 

Ablation  of  the  mammje 


tot 
loH 
758 
759 
759 
760 
760 
761 
765 
768 
769 
770 
770 
771 


DISEASES   OF  CATTLE,    SHEEP, 
GOATS  AND  SWINE. 

SECTION    I. 

DISEASES  OF  THE  ORGANS  OF  LOCOMOTION. 

METHODS    OF    EXAMINATION. 

Accidental  and  local  diseases  of  the  apparatus  of  locomotion  are 
matters  of  less  urgency  in  the  case  of  cattle  than  in  that  of  the  horse. 
On  the  other  hand,  general  affections,  such  as  rheumatism  and  osseous 
cachexia,  demand  a  larger  share  of  attention,  and  are  of  the  utmost 
importance. 

As  the  accurate  diagnosis  of  any  disease  demands  careful  and 
systematic  examination,  the  practitioner  usually  observes  a  certain 
order  in  his  investigations,  as  indicated  below  : — 

(1.)  Inspection,  from  the  side,  from  the  front  and  from  behind,  re- 
veals the  existence  of  deformities  of  bones,  limbs,  muscles  and  joints, 
articular  displacements,  and  irregularities  of  conformation  or  of  gait. 

By  inspection  of  an  animal  as  it  walks  various  forms  of  lameness,  and 
their  particular  characteristics,  are  rendered  visible. 

(2.)  Palpation  and  pressure  will  detect  changes  in  local  sensibility, 
the  softness  or  hardness  of  tissues,  the  existence  of  superficial  or  deep 
fluctuation,  (Edematous  swelling,  and  abnormal  growths  like  ring-bones 
and  exostoses,  as  well  as  the  exact  character  of  articular  eidargements. 

(3.)  Percussion  is  of  little  value  in  examining  the  apparatus  of  loco- 
motion. Nevertheless,  percussion  of  the  claws,  and  of  certain  bones  of 
the  limbs,  or  of  flat  bones,  may  afford  valuable  information  in  cases  of 
laminitis,  ostitis,  and  periostitis.  Percussion  along  the  longitudinal 
axes  of  the  limb  bones  is  also  useful  in  diagnosing  intra-articular  frac- 
tures, sul)-acute  arthritis,  osteomyelitis,  etc. 

(4.)  The  gait.  Lame  animals  should  be  made  to  move,  in  order  to 
assist  both  in  discovering  the  cause,  and  in  estimating  the  gravity  of  the 
condition.  Sometimes  it  is  advisable  to  turn  the  animal  loose,  but  most 
frequently  it  is  moved  in  hand,  either  in  straight  lines  or  in  circles. 

D.C.  B 


2  DISEASES   OF   THE   ORGANS   OF   LOCOMOTION*. 

Information  so  obtained  should  always  be  supplemented  by  local 
manipulation  and  by  passive  movement,  such  as  flexion,  extension, 
abduction,  adduction  and  rotation  of  the  joints. 

A  knowledge  of  the  characteristics  of  normal  movement  in  any  given 
joint,  renders  it  comparatively  easy  to  detect  abnormality,  such  as 
increased  sensibility,  articular  crepitation  or  friction,  and  to  diagnose 
fractures  with  or  without  displacement,  ruptures  of  tendons  or 
ligaments,  etc. 


CHAPTER    I. 

DISEASES    OF    BONES. 

The  diseases  affecting  bony  tissues  may  broadly  be  divided  into  local 
and  general.  Local  diseases  like  ostitis,  periostitis,  necrosis,  fracture, 
etc.,  are  somewhat  rare,  and  are  less  important  in  cattle  than  such 
general  diseases  as  rachitis  and  osseous  cachexia. 

Eachitis  is  a  disease  of  young  animals,  and  occurs  during  the  growing 
period.  Osseous  cachexia  is  a  disease  of  adults.  Nevertheless,  there  is 
a  relationship  between  these  two  morbid  conditions,  for  they  frequently 
co-exist  in  one  family.  Moreover,  brood  mares  and  cows  suffering  from 
osseous  cachexia  give  birth  to  foals  and  calves,  which,  if  left  with  their 
mothers,  almost  inevitably  become  rachitic. 

The  general  characteristic  common  to  both  rachitis  and  osseous 
cachexia  consisting  in  diminution  in  the  normal  proportion  of  mineral 
salts  entering  into  the  constitution  of  the  bone,  numerous  theories  have 
been  advanced  to  explain  this  irregularity  in  nutrition. 

The  theory  of  insuflBciency  is  one  of  the  oldest.  It  presupposes  that 
the  young  animals'  food  contains  insufficient  mineral  salts  necessary  for 
building  up  the  skeleton,  hence  rachitis ;  or  again,  that  the  daily  food 
of  the  adults  does  not  afford  sufficient  mineral  salts  to  compensate  for 
the  normal  transformation  which  is  continually  going  on  within  the 
organism,  and  for  the  direct  losses  which  occur  through  the  medium  of 
the  urine,  milk,  etc. 

This  extremely  simple  theory  appears  perfectly  logical,  but  unfortu- 
nately does  not  fit  in  with  all  the  observed  facts.  In  reality,  rachitis 
attacks  children  whose  supply  of  milk,  from  a  chemical  point  of  view, 
leaves  nothing  to  be  desired.  The  same  is  true  of  animals,  particularly 
of  young  pigs.  The  so-called  "acid  theory"  has  therefore  been  ad- 
vanced to  explain  the  points  left  obscure  by  its  predecessor. 

The  acid  theory.  According  to  this  theory,  the  food  may  contain 
more  than  sufficient  mineral  material  without,  however,  preventing  the 
development  of  rachitis  or  of  osseous  cachexia. 

In  animals  suffering  from  digestive  disturbance  the  alimentary  tract 
may  become  the  seat  of  excessive  fermentation  or  of  changes  in  secretion. 
There  is  thus  produced  an  excess  of  lactic  acid  which  passes  into  the 

13   2 


4  DISEASES   OF    BONES. 

circulation  and  accumulates  in  the  tissues,  checking  the  processes  which 
end  in  ossification  or,  in  the  case  of  adults,  even  leading  to  decalcification. 

It  seems  fairly  well  estahlished  that  experimental  administration  of 
lactic  acid  to  animals  causes  diminution  in  the  quantity  of  calcium  salts 
contained  in  the  hones  (Siedamgrotsky,  Hofmeister).  On  the  other  hand 
however  Arloing  and  Tripier  failed  to  produce  rachitis  experimentally. 

Bouchard  revived  this  theory  in  a  somewhat  modified  form.  He  con- 
siders that  calcium  salts  are  ahsorhed  as  carbonates  and  chlorides  and 
phosphoric  acid  as  phospho-glyceric  acid.  The  reaction  which  these 
compounds  undergo  within  the  organism  ends  in  the  formation  of  the 
phosphate  of  calcium  necessary  to  ossification,  but  this  "  phosphate  of 
ossification  "  cannot  be  deposited  if  the  organism  contains  an  excess  of 
lactic  acid. 

Theory  of  inflammation.  A  third  theory  which  until  now  has  received 
very  little  support  is  that  called  the  theory  of  inflannnation.  The  general 
lesions  which  characterise  rachitis  are  regarded  as  resulting  from  primary 
attacks  of  ostitis  and  osteo-periostitis.  The  cause  of  these  forms  of 
inflammation  is  not  suggested. 

To  the  above  views  may  be  added  that  more  recently  emitted  by 
Dr.  Chaumier,  according  to  which  rachitis  is  of  an  infectious  nature. 
Unfortunately  no  proof  of  this  has  yet  been  adduced. 


GENERAL    DISEASES. 

RACHITIS. 

Eachitis  is  a  disease  of  youth,  and  is  common  both  to  the  human 
species  and  to  all  domestic  animals.  It  is  characterised  by  irregularities  in 
development  and  by  imperfect  consolidation  of  the  bones.  The  boundary 
between  rachitis  and  osseous  cachexia  is  difficult  to  define  and  in  fact 
at  the  present  moment  the  two  diseases  can  scarcely  be  defined  with 
exactitude.  Eachitis  again  is  often  complicated  with  softening  of  the 
bones,  disease  of  the  limbs,  arrested  development,  etc.,  but  it  must  not  be 
forgotten  that  although  the  irregularities  in  ossification  and  development 
of  the  skeleton  are  the  symptoms  most  striking  to  the  eye,  they  do  not  stand 
alone,  and  that  from  the  point  of  view  of  development  all  the  tissues, 
including  the  muscles,  are  more  or  less  affected  and  that  most  of  the 
physiological  functions  such  as  digestion  and  the  secretion  of  urine  are 
deranged. 

Etiology.  One  of  the  principal  causes  suggested  is  that  of  heredity, 
and  so  far  as  human  beings  are  concerned,  one  seldom  fails  to  discover 
the  rachitic  taint.  Certainly  the  offspring  of  individuals  marked  by  any 
debilitating  disease  like  alcoholism,  tuberculosis,  syphilis,  etc.,  are  poorly 


RACHITIS.  5 

equipped  for  their  future  development.  Their  tissues  lack  the  necessary 
qualities  and,  c ceteris  pavihus,  their  physiological  functions  are  performed 
less  perfectly  than  are  those  of  normal  individuals. 

It  is  difficult  to  apply  such  information  to  domestic  animals,  because 
badly  developed  subjects  are  not  used  for  reproduction  and  the  import- 
ance assigned  to  heredity  can  therefore  scarcely  be  sustained.  The 
conditions  of  life,  on  the  contrary,  have  an  unquestionable  influence, 
and  if  rachitis  is  so  frequent  in  young  animals  living  near  towns,  for 
example,  it  is  undoubtedly  due  to  that  want  of  air,  light  and  liberty, 
which  first  affects  the  mother's  health  and  later  that  of  her  offspring. 

The  same  may  be  said  of  insufficient  and  improper  food  ;  for  in  this 
connection  quality  is  of  even  greater  importance  than  quantity.  Even 
free  feeding  is  insufficient  if  the  fodder  does  not  contain  the  material 
necessary  for  sustaining  and  building  up  the  developing  frame,  a  point 
which  readily  explains  the  occurrence  of  rachitis  when  young  animals 
receive  a  diet  deficient  in  certain  chemical  constituents. 

This  occurs  in  young  lambs  and  pigs  where  the  mothers  are  given  too 
little  variety  or  too  small  a  quantity  of  food. 

In  calves  and  foals  rachitis  is  rare  but  occurs  when  the  mothers  are 
exhausted  or  cachectic  or  are  debilitated  by  chronic  wasting  diseases  like 
tuberculosis  or  osseous  cachexia.  The  milk  is  then  no  longer  of  normal 
chemical  constitution. 

One  fact  appears  to  dominate  the  whole  subject  of  the  causation  of 
rachitis,  viz.,  the  failure  to  assimilate  sufficient  of  the  mineral  salts 
required  in  building  up  the  skeleton.  This  failure  to  assimilate  may  be 
caused  by  too  meagre  feeding,  but  even  when  the  food  is  sufficiently  rich, 
some  digestive  disturbance  may  reduce  the  amount  absorbed  below 
normal.  This  appears  the  only  plausible  explanation  unless  we  admit  Dr. 
Chaumier's  theory  that  the  disease  is  of  an  infectious  character. 

Symptoms.  The  onset  is  absolutely  insidious  and  the  diagnosis  of 
rachitis  is  never  made- until  nutrition  has  long  been  abnormal. 

This  disturbance  of  nutrition  is  revealed  by  irregularity  and  abnor- 
mality in  appetite,  by  difficulty  in  rising  and  moving  about,  and  by  the 
animals  lying  down  for  long  periods.  The  subjects  are  feeble,  sluggish 
and  badly  developed. 

Next  supervenes  the  second  phase  characterised  by  deformity  of  bones. 
This  is  of  two  kinds — deformity  in  the  neighbourhood  of  joints  (deformity 
or  enlargement  of  the  epiphyses)  and  deformity  of  the  diaphyses.  The 
former  results  from  irregularity  in  ossification  of  the  articular  cartilages. 
The  latter  is  followed  by  loss  of  rigidity  in  the  bones  of  the  limbs  which, 
under  the  influence  of  the  body  weight  and  of  muscular  contraction,  bend 
in  different  directions. 

The    bones  appear    of   increased   thickness  principally  towards  the 


RACHITIS. 


articulations.     The  latter  are  deformed,   and  on  palpation  are  found  to 
be  surrounded  by  uneven  and  irregular  growths. 

The  front  limbs  are  distorted.  In  young  pigs,  lambs,  and  less 
frequently  in  foals,  calves  and  dogs,  the  jaws  become  deformed,  and 
mastication  is  rendered  difficult. 

The  vertebral  column  may  also  l)e  affected,  and  lordosis  (bending 
downwards  of  the  l)ack)  or  skoliosis  (lateral  bending  of  the  back)  is  some- 
what frequent. 

Cyphosis,  or  ui)ward  l)ending  of  the  back,  seldom  occurs,  and  when 
seen,  sometimes  results  from  disease  other  than  rachitis. 

General  development  is  always  in- 
terfered with  and  the  young  creatures 
are  generally'  dwarfed. 

The  digestive  apparatus  is  dis- 
ordered, the  appetite  is  irregular  and 
sometimes  depraved,  w^hile  indiges- 
tion, gastritis,  and  enteritis  are  not 
exceptional.  Physiological  and  patho- 
logical research  has  shown  that  the 
quantity  of  phosphoric  acid  elimi- 
nated in  twenty- four  hours  in  a 
rachitic  child  is  double  the  quan- 
tity passed  b}^  a  healthy  infant. 
The  amount  of  urea  in  the  urine 
(whicli  is  a  criterion  of  nutrition,  and 
usually  varies  in  proportion  to  the 
amount  of  food  ingested)  is,  on 
the  contrary,  diminished  even  when 
highly  nitrogenous  food  is  given, 
thus  suggesting  diminution  in  nu- 
trition. 
Lesions.  The  lesions  are  represented  by  abnormal  and  irregular 
tliickening  around  the  inter-articular  cartilages.  The  cartilage  is 
thickened,  compressible,  very  spongy  and  without  regular  ossification. 
Diffused  periostitis  exists  principally  towards  the  extremities  of  the  bone. 
Beneath  the  periosteum  the  surface  of  the  bone  appears  rough  and 
softened.  On  section  the  medullary  canals  are  seen  to  be  enlarged  and 
filled  with  marrow  of  a  gelatinous  character.  The  Haversian  canals  are 
dilated,  and  the  entire  tissue  appears  very  vascular.  Chemical  analysis 
proves  that  the  mineral  constituents  of  the  bone,  particularly  the  phos- 
phates, have  diminished  by  one-half ;  the  organic  constituents  on  the 
other  hand  are  increased  in  a  similar  ratio,  but  the  ossein  is  abnormal. 
Ossification  has,  in  a  word,  been  incomplete. 


Fig.  1.— liachitis  ui  a  voiui"  ''oat. 


RACHITIS.  7 

Diagnosis.  Diagnosis  presents  no  difficulty  except  in  the  early  stages 
before  deformity  has  occurred. 

Eachitis  can  scarcely  be  mistaken  for  any  other  condition  except 
perhaps  infectious  rheumatism,  but  the  rapid  course  of  the  disease  in  the 
latter  case,  the  persistence  of  fever  and  the  swelling  of  the  joint  cavities 
sufficiently  differentiate  the  conditions  provided  care  is  exercised. 

Prognosis.  From  an  economic  point  of  view  the  prognosis  is  very 
grave  for  if  the  lesions  are  extensive  there  is  nothing  to  be  gained  by 
keeping  the  animal. 

Treatment.  Treatment  differs  very  little,  whether  the  animals  are 
still  being  suckled  or  have  been  weaned.  In  the  former  case  it  is 
necessary  to  improve  the  quality  and  chemical  constitution  of  the 
mother's  milk  by  giving  food,  richer  both  in  mineral  salts  and  in 
nitrogenous  material. 

Cooked  grains,  milk,  and  forage  of  good  quality  should  be  given  freely. 
When  the  mothers  are  exhausted  and  anaemic  it  is  better  to  feed  the 
little  animals  artificially  or  to  change  them  to  a  foster-mother.  Those 
already  weaned  should  be  given  good  rich  milk,  eggs,  boiled  gruel,  and 
drugs,  such  as  the  phospho-chlorate  of  lime,  1  to  1^  drachms  per  day  (for 
a  calf) ;  lacto-phosphate  of  lime,  1  to  1^  drachms  ;  bi-phosphate  of  lime, 
1  drachm,  or  simply  ordinary  phosphate  of  lime.  Oil  containing  1  per 
cent,  of  dissolved  phosphorus  may  be  given  in  doses  of  1  to  2^  drachms, 
according  to  the  size  of  the  calves,  but  its  use  calls  for  much  care,  and  it 
should  only  be  given  for  alternate  periods  of  a  fortnight.  The  glycero- 
phosphates are  not  very  active.  Beef  meal  in  doses  of  6  drachms  to 
li  ounces  and  chloride  of  ammonium  in  doses  of  30  to  60  grains  have 
also  been  used  advantageously.  The  above  drugs,  but  particularly  the 
bi-phosphate  of  lime  and  chloride  of  ammonium,  stimulate  nutrition  and 
diminish  the  quantity  of  phosphoric  acid  eliminated. 

OSSEOUS    CACHEXIA. 

"  Osseous  cachexia  "  is  a  general  disease  which  develops  slowly  and 
progressively,  producing  its  most  marked  effects  on  the  bony  tissues. 
It  has  received  a  great  many  diflereht  names,  such  as  osteoporosis, 
osteoclastia,  osteomalacia,  fragilitas  ossium,  enzootic  ostitis,  bone 
softening,  etc.,  but  none  of  these  appears  so  appropriate  as  the  term 
osseous  cachexia,  suggested  by  Cantiget. 

All  the  above-mentioned  names  are  applicable  to  some  phase  of  the 
disease,  but  none  to  the  disease  in  its  complete  development.  Thus  the 
name  "  osteoporosis,"  accepted  by  German  authors,  is  quite  applicable 
to  the  phase  of  rarefying  ostitis  seen  at  the  commencement,  but  this 
condition  occurs  in  other  diseases.     The  expressions  "  osteoclastia  "  and 


8  OSSEOUS   CACHEXIA. 

"  fragilitas  ossium  "  suggest  the  fragility  of  the  bones  and  the  common- 
ness of  fracture.  The  term  "osteomalacia"  is  warranted  during  the 
period  of  bone  softening.  The  term  "gout,"  though  in  practice  confusing, 
has  l)een  held  to  be  justified  by  the  frequent  appearance  of  synovitis  and 
arthritis;  while  that  of  "enzootic  ostitis"  indicates  the  appearance  of 
the  disease  in  all  the  stables  in  one  district,  without  however  pointing 
to  its  nature.  It  is  possible  that  under  certain  circumstances  the  train 
of  symptoms  might  be  incomplete,  and  then  the  terms  above  indicated 
would  be  quite  inappropriate.  "Osseous  cachexia,"  on  the  other  hand, 
is  very  comprehensive,  and  appears  to  cover  the  entire  development  of 
the  disease,  for  which  reason  it  here  receives  preference. 

Law  defines  the  disease  as  "a  softening  and  fragility  of  the  bones  of 
adult  animals,  in  connection  with  solution  and  removal  of  the  earthy 
salts."  He  descabes  it  as  an  enzootic  disease  of  mature  animals — mainly 
cows — in  which  the  decalcifying  process  proceeds  most  actively  in  the 
walls  of  the  Haversian  canals  and  cancelli  of  the  affected  bones.  In 
consequence  of  the  removal  of  the  earthy  salts  the  bones  become  soft 
and  more  or  less  fragile. 

The  disease  has  been  observed  in  England,  Scotland,  United  States, 
France,  Belgium,  and  Jutland,  and  generally  in  districts  with  low- 
lying  damp  pastures.  It  attacks  cows  which  are  heavy  milkers. 
Susceptibility  appears  to  increase  with  advancing  age. 

History.  Having  been  described  by  Vegetius,  the  disease  was  again 
observed  about  1650  in  Norway  where  it  was  treated  by  the  administra- 
tion of  crushed  bones.  It  is  fairly  frequent  in  some  parts  of  Germany 
and  Belgium.  In  France  it  was  studied  in  1825  by  lioux,  and  in  1846 
by  Dupont,  but  Zundel  in  1870  was  the  first  who  gave  a  good  description 
of  it,  founded  partly  on  the  authority  of  German  authors  and  partly  on 
observations  made  by  himself  in  the  Valley  of  the  Lower  Ehine.  Since 
that  time  it  has  successively  been  reported  in  the  Yonne  by  Thierry,  in 
the  Nievre  by  Vernant,  in  the  Aube  by  Collard  and  Henriot  (1893),  in 
the  Indre  by  Cantiget,  as  well  as  in  La  Vendee  by  Tapon  in  1893.  In 
that  and  the  succeeding  year  Moussu  also  saw  numerous  cases  in  the 
districts  of  Indre-et-Loire,  Loire-et-Cher,  Berry,  Sologne,  and  in  some 
parts  of  Beauce. 

Symptoms.  The  first  symptoms  are  difficult  to  detect  and  interpret, 
especially  at  the  commencement  of  an  outbreak  and  in  parts  where  the 
disease  is  rare  they  may  lead  to  confusion  and  errors  in  diagnosis.  On 
the  other  hand,  in  regions  where  the  disease  is  common  the  practitioner 
will  be  able  to  form  his  diagnosis  from  the  appearance  of  the  first  signs. 

To  render  clear  the  mode  in  which  the  symptoms  develop  we  may 
divide  the  progress  of  the  disease  into  four  phases,  though  this  grouping 
is  somewhat  arbitrary. 


OSSEOUS    CACHEXIA.  .  9 

1.  The  initial  phase  is  not  ^Yell  marked,  and  is  announced  by  digestive 
disturbance  and  by  wasting.  The  former  of  these  symptoms  may  be 
referred  to  some  other  cause,  but  consists  in  irregularity,  diminution 
and  sometimes  perversion  of  the  appetite.  These  earlier  signs  are  soon 
followed  by  loss  of  spirits,  and  some  interference  with  movement,  but 
the  symptoms  only  become  of  importance  or  attain  their  full  develop- 
ment when  the  animals  remain  lying  for  a  long  period  in  the  stable. 

2.  The  second  phase  is  characterised  by  more  precise  signs,  which 
become    almost    pathognomonic.     Difficulty  in  rising  is  added   to   the 


Fig.  2. — Horse  suffering  from  osseous  cachexia. 

alread}^  existing  tendency  to  remain  lying,  and  to  the  interference  with 
movement. 

When  _  lying  down  the  patient  no  longer  responds  to  the  trifling 
stimulus,  which  a  healthy  animal  needs  to  cause  it  to  rise.  It  remains 
languid  and  apparently  lazy,  though  in  reality  it  experiences  pain 
and  difficulty  on  attempting  to  get  up.  The  least  muscular  effort  when 
lying  down  often  causes  it  to  moan,  as  do  efforts  to  change  its  position 
or  to  walk.  Even  when  standing  still,  it  may  appear  to  be  in  pain, 
and  patients  often  assume  a  position  similar  to  that  of  a  horse  suffering 
from  laminitis. 

At  the  end  of  this  second  phase,  swellings  appear,  due  to  synovitis  or 
arthritis  of  the  extremities,  synovitis  of  the  sesamoid  or  navicular 
sheaths  or  to  inter-phalangeal  arthritis  or  arthritis  of  the  fetlock  joint. 
Weakness  becomes  marked,  and  the  appetite  is  very  irregular. 


10  OSSEOUS   CACHEXIA. 

Secretion  of  milk  diminislies  or  ceases  and  abortion  is  not  un- 
common . 

3.  The  third  phase  is  characterised  by  fractures,  and  it  is  this 
pecuHarity  of  the  disease  which  has  procured  for  it  the  names  of  fragi- 
litas  ossium,  and  osteoclastia.  These  fractures  may  affect  any  portion 
of  the  skeleton.  Animals  so  suffering  sometimes  break  a  leg  whilst 
trotting  or  the  pelvis  in  simply  jumping  over  a  ditch;  a  collision  with  a 
fixed  object  like  the  jamb  of  the  stable  door,  or  a  fall  on  the  ground, 
may  result  in  the  fracture  of  one  or  several  ribs. 

Such  shocks  would  be  of  no  importance  to  a  healthy  animal,  but  to 
one  suffering  from  osseous  cachexia,  any  violence,  or  even  the  slightest 


Fig.  3. — Pig  suffering  fioiii  osseous  cachexia  (foiu'tli  stage). 

muscular  effort  may  be  follow^ed  by  fracture  of  the  gravest  character, 
involving  even  the  vertebral  column.  In  cows  the  pelvis,  femur,  and 
tibia  are  most  frequently  injured. 

In  horses,  particularly  in  riding  horses,  fractures  are  commonest  in 
the  region  of  the  forearm,  cannon  bone,  and  anterior  phalanges.  So 
extremely  fragile  are  the  bones  at  this  stage  that  the  horse  represented 
herewith  broke  twelve  ribs  at  one  time  by  simply  falling  on  its  side.  It 
is  interesting  to  note  that  such  fractures  are  never  accompanied  by  any 
extensive  bleeding.  They  Imve  little  tendenc}^  to  repair,  no  real  callus 
formation  occurs,  and  on  post-mortem  examination  one  often  finds  the 
ends  unconnected  by  temporary  callus,  worn,  and  rounded  by  reciprocal 
friction. 

At  this  stage  but  under  other  circumstances,  the  animals  show  great 
reluctance  to  rise,  remaining  down  for  twelve  to  twenty-four  hours 
without  shifting  their  position.  If  forced  to  get  up,  they  stand  as 
though  fixed  in  one  position,  the  respiration  and  circulation  become  rapid, 
and  they  soon  grow  tired  and  fall. 


OSSEOUS   CACHEXIA. 


11 


i.  The  fourth  phase,  or  period  of  osteomalacia,  i.e.  softening  of  the 
bones,  is  also  the  last.  It  is  rarely  seen  in  large  animals  like  horses  and 
oxen,  because  accidents  so  often  accompany  the  preceding  stages  and 
necessitate  slaughter  ;  but  it  is  common  in  goats  and  pigs. 

In  this  phase  the  bones  become  elastic,  soft  and  depressible,  yielding 
to  the  pressure  of  the  operator's  fingers. 

The  flat  bones  are  particularly  liable  to  this  change,  which  is  common 
to  domesticated  animals.  The  bones  of  the 
head  are  the  first  to  suffer ;  later  those  of  the 
pelvis.  The  lower  jaw  becomes  sw^ollen,  par- 
ticularly about  the  centre  of  the  branches 
which  may  attain  three,  four,  or  five  times, 
their  normal  thickness. 

The  depression  in  the  submaxillary  space 
disappears.  The  upper  jaw  undergoes  similar 
changes,  becoming  deformed  and  thickened 
until  the  cavities  of  the  sinuses  and  the 
hollow  appearance  of  the  palate  are  lost,  while 
the  face  is  so  changed  that  it  cannot  be 
recognised  as  that   of  a  horse,  goat,  etc. 

The  molar  teeth  are  almost  buried,  their 
tables  alone  being  visible  at  the  bottom  of  a 
depression,  the  edges  of  which  rise  above  the 
neighbouring  parts  (pig). 

Mastication  is  clearly  impossible,  the  jaws 
appear  paralysed,  the  muscles  powerless,  and 
only  swallowing  is  possible,  a  fact  which 
explains  why  life  is  only  prolonged  to  this  stage 
in  animals  which  can  be  fed  with  a  spoon  or 
bottle  (pigs  and  goats).  The  bones  of  the 
cranium,  although  greatly  changed  in  texture,  are  always  less  deformed 
than  those  of  the  face. 

The  changes  are  such  that  it  is  often  easy  with  a  mere  post-mortem 
knife  to  cut  the  head  completely  in  two.  Osseous  tissue,  properly 
so-called,  has  disappeared. 

All  the  constituent  tissues,  with  the  exception  of  the  skin  and  muscles, 
i.e.,  the  bone,  periosteum  and  aponeuroses,  have  the  appearance  and 
consistence  on  section  of  the  fibro-lardaceous  tissue  seen  in  chronic 
inflammation. 

The  following  is  a  condensed  description  of  the  disease  as  given  by 
Law : — 

Symptoms.  Poor  condition  or  even  emaciation,  with  very  visible 
projection  of  the  bones.     The  coat  is  rough,  skin  tense,  inelastic  s^nd 


Fio.  4 


Deformity  of  the 
face  in  the  horse  shown 
in  Fig.  2. 


12  OSSEOUS   CACHEXIA. 

hidebound,  appetite  variable,  sometimes  impaired,  and  nearly  always 
perverted  (or  depraved)  so  that  the  i^atient  will  lick  the  manger  con- 
tinually or  pick  up  and  chew  all  sorts  of  objects :  bones,  leather, 
clothing,  wood  or  iron,  stones,  etc.  The  amount  of  food  consumed 
may,  however,  be  up  to  the  normal.  The  most  marked  feature  is  the 
difficulty  and  stiffness  of  locomotion.  .  .  .  Temperature  and  yield 
of  milk  may  remain  normal. 

"  Later,  appetite  and  milk  secretion  fail,  temperature  rises  a  degree 
or  two,  the  animal  refuses  to  rise,  remaining  down  twelve  to  twenty-four 
hours  at  a  time,  and  .  .  .  when  rising  .  .  .  remaining  on  the 
knees  for  a  time,  moaning  and  indisposed  to  exert  itself  further.  At 
this  stage  many  cases  begin  to  improve  and  may  get  well  in  live  or  six 
weeks.      Some  will  remain  down  for  several  weeks  and  finally  get  up 


FiG.  5. — Head  of  a  pig  suffering  from  osseous  cachexia. 

and  recover.  With  constant  decubitus,  however,  the  animal  falls  off 
greatly,  becoming  emaciated  and  weak,  the  appetite  may  fail  altogether, 
and  the  patient  is  worn  out  by  the  persistent  fever,  nervous  exhaustion 
and  poisoning  from  the  numerous  bed-sores  .  .  .  which  are  common 
over  the  bony  prominences.  It  is  in  these  last  conditions,  above  all, 
that  fractures  and  distortions  of  the  pelvic  bones,  and  less  frequently  of 
the  bones  of  the  legs  occur." 

"  The  disease  may  advance  for  two  or  three  months,  and  in  case  of 
pelvic  fractures  and  distortions,  there  may  be  permanent  lameness,  and 
dangerous  obstruction  to  parturition,  even  though  the  bones  should 
acquire  their  normal  hardness  through  the  deposition  of  lime  salts." 

In  horses,  the  different  phases  of  the  disease  develop  precisely  as  in 
bovines.  The  apparent  differences  between  affected  horses  and  cattle 
result  in  reality  from  differences  in  their  capacity  for  continuing  work. 
In  the  first  phase,  horses  are  incapable  of  work,  their  movements  being 


OSSEOUS    CACHEXIA, 


18 


badly  co-ordinated.     They  are  inclined  to  stumble,  and  appear  as  though 
suffering  from  strain  of  the  lumbar  muscles. 

In  the  second  phase  pain  referable  to  the  bones  sets  in.  Lameness 
develops  without  visible  lesions  and  is  rapidly  followed  by  synovitis  and 
arthritis  in  the  lower  portions  of  the  limbs,  and  by  wasting  and  anasmia. 

The  animals  seem  unable  to  move  rapidly,  or  if  forced  to  do  so  may 
sustain  fractures  even  at  a  trot :  the  limb  bones  sometimes  break  or 
ligamentous  insertions  in  the  neighbourhood  of  joints  are  torn  away, 
resulting  in  sudden  falls  on  the  ground  and  fracture  of  ribs  or  even  of 
the  vertebral  column.  This  corresponds  to  the 
third  phase,  osteoclastia,  in  oxen. 

From  then  onwards,  horses  become  useless 
and,  if  not  destroyed,  may,  after  a  few  weeks 
or  months,  develop  the  condition  known  as 
osteomalacia,  in  which  the  flat  bones  become 
softened,  the  head,  the  branches  of  the  lower 
jaw  and  the  face  become  deformed,  while 
mastication  and  other  functions  are  impeded. 

Germain  gives  the  above  symptoms  as 
characteristic  of  the  mode  of  development  of 
the  disease  in  French  and  Algerian  horses 
imported  into  Tonquin,  and  his  description, 
written  several  years  ago,  is  fully  confirmed  by 
more  recent  observations.  Since  Tonquin  was 
taken  over  by  the  French,  however,  improved 
methods  of  culture  have  resulted  in  the  produc- 
tion of  better  cereals  and  forage ;  the  fodder 
plants  have  been  vastly  improved,  to  the  great 
benefit  of  imported  animals. 

In  the  goat,  the  disease  shows  some  slight 
peculiarities.  Thus,  in  the  second  phase,  during 
which  goats  and  sheep. suffer  so  markedly  from 
lameness  and  pain  in  the  bones,  goats  often 
walk  on  the  knees.  The  disease,  however,  is  uncommon  in  these  animals. 
The  phase  of  osteoclastia  is  also  less  marked  and  fractures  are  rare, 
because  the  animals  weigh  less  and  also  because  they  are  less  exposed 
to  falls  and  violent  shocks.  The  bones,  nevertheless,  are  extremely 
fragile  and  fractures  may  be  produced  at  will. 

Osteomalacia,  on  the  other  hand,  is  always  well  marked. 

Eegarding  the  development  of  the  disease  in  pigs,  we  may  repeat  what 
has  just  been  said  respecting  the  goat.  Walking  on  the  knees  is  often 
one  of  the  first  signs,  fractures  are  somewhat  rare,  and  the  period 
of  softening  and  deformity  is  always  very  noticeable. 


Fig.  6.— Osseous  cachexia. 
Tills  condition  (le\  eloped 
in  two  months,  the  last 
month  of  gestation  and 
the  first  of  lactation. 


14  OSSEOUS   CACHKXIA. 

Course.  The  development  of  the  disease  is  slow,  lasting  from  one  to 
three  months  as  a  rule,  and  is  little  influenced  hy  hygienic  conditions. 
Good  milking  cows,  however,  seem  to  be  most  frequently  attacked, 
probably  because  of  the  great  losses  of  nutritive  material  which  occur 
through  the  milk.  The  calves  borne  by  such  animals  are  often  rachitic. 
Oxen  are  less  commonly  attacked.  Horses  rarely  suffer  from  the  disease 
in  France,  but  frequently  in  Tonquin.  Pigs  reared  on  very  poor  soil 
seldom  escape  attack. 

If  treated  from  the  beginning,  or  even  before  the  second  phase  has 
become   well   developed,    the   disease    may    be    cured,    but    after    this 

period  little  improvement  need  be 
expected. 

Causation.  The  prol^lem  of  why 
^^  osseous  cachexia  occurs  has  natu- 

rally given  rise  to  numerous 
explanations,  some  plainly  inad- 
missible, others,  however,  of  greater 
or  less  plausibility. 

The  fact  which,  from  the  earliest 
times,  appears  to  have  attracted 
most  attention  is  the  relation 
defective  nourishment  bears  to 
development  of  the  disease.  In 
Norway,  as  early  as  the  year  1650, 
the  plant  known  as  sterregraes 
(which  renders  animals  dull  and 
heavy)  was  thought  to  be  the  cause 
of  the  disease ;  two  centuries  later, 
in  1846,  the  Anthericum  ossifragnm 
Fig.  7.-0sseous  cachexia:  softening  of  ^^^^^^  similarly  regarded.  Zundel, 
the  maxillae.  .      ^^    ^      ,    .        -,  ,.     ,    ,,      ^, 

ni  1870,  clanned  that  the  Grermans 

first  referred  the  development  of 
the  disease  to  chemically  incomplete  forms  of  nourishment.  This  opinion 
seems  fully  confirmed  by  the  remarkable  observations  of  Germain  on 
European  horses  imported  into  Cochin- China,  and  it  is  finally  placed 
beyond  question  by  the  work  of  Cantiget.  Basing  his  researches  on 
analysis  of  the  soib  he  proved  that  osseous  cachexia  only  occurs  in  cattle 
depastured  on  land  which  is  too  poor  in  phosphoric  acid  and  calcium 
phosphate,  and  that  it  can  be  banished  by  enriching  the  soil  with  suitable 
manures  up  to  a  point  when  the  proportion  of  phosphoric  acid  becomes 
normal.  In  good  land,  suitable  for  raising  cattle,  the  proportion  of  phos- 
phoric acid,  according  to  the  best  exponents  of  agricultural  chemistry, 
should  not  fall  below  4,000  kilograms  to  the    hectare.      Cantiget  and 


OSSEOUS   CACHEXIA.  15 

Brissonet  have  shown  that  where  the  soil  contams  less  than  1,500  kilo- 
grams to  the  hectare,  osseous  cachexia  is  almost  permanently  present. 
As  soon,  however,  as  this  proportion  is  raised  ahove  2,000  kilograms  by 
suitable  culture,  the  losses  diminish,  and  the  cachexia  finally  disappears. 

This  view  was  greatly  strengthened  by  fodder  analyses,  which  showed 
that  in  all  cases  where  the  soil  is  poor  in  calcium  phosphate,  the  forage 
is  poor  in  phosphoric  acid,  and  vice  versa.  The  food  is  too  poor  in 
mineral  salts,  firstly  for  normal  development ;  and  secondly  for  the 
proper  nutrition  of  the  skeleton. 

Germain  is  of  a  similar  opinion  with  regard  to  the  occurrence  of 
osseous  cachexia  in  horses  in  Cochin- China,  where  the  soil  is  very  poor 
in  lime.  The  fodder  and  cereals  are  poor  in  mineral  salts,  and  even 
when  given  in  large  quantities  do  not  furnish  proper  (chemical)  nutri- 
tion. Clear  proof  of  the  correctness  of  this  view  is  afforded  by  the  fact 
that  feeding  with  forage  and  cereals  obtained  from  France  or  Algeria 
prevents  the  disease  appearing,  or  diminishes  and  finally  removes  the 
previously  existing  symptoms.  Furthermore,  Germain  shows  that 
Europeans,  living  solely  on  the  products  of  the  country,  to  some  extent 
suffer  like  the  horses. 

This  theory  though  based  on  sufficiently  solid  foundations  to  carry 
conviction,  has  been  questioned,  and  it  may  be  desirable  to  record  briefly 
the  criticisms  advanced  against  it. 

One  of  the  most  important  is  as  follows : — 

As  osseous  cachexia  of  oxen  occurs  in  certain  well-defined  districts  in 
France,  and  seems  due  to  the  feeding,  why  does  it  not  attack  horses  in 
the  same  regions  in  an  enzootic  form?  The  answer  appears  to  be  that 
horses  receive  a  greater  amount  of  rich  food,  particularly  of  cereals, 
which  contain  much  larger  amounts  of  mineral  salts,  including  phos- 
phates, than  does  ordinary  forage. 

The  most  serious  objection  was  made  by  Tapon,  who  states  that  in  • 
1893  he  saw  osseous  cachexia  in  oxen  on  farms  in  La  Vendee  where 
superphosphate  had  been  used  for  years,  wdiilst  the  disease  did  not  exist 
on  other  farms  wdiere  such  chemical  manures  were  not  employed. 
Before  attaching  much  weight  to  this  objection,  however,  it  would  be 
necessary  to  know^  the  richness  in  phosphoric  acid  of  the  soil  on  the 
respective  farms,  for  it  is  possible  that,  in  consequence  of  natural  condi- 
tions and  in  spite  of  the  use  of  certain  mineral  manures,  the  richness  of 
the  soil  on  the  first-mentioned  farms,  though  manured  with  superphos- 
phates, was  still  below  that  of  the  others  which  had  received  no  artificial, 
manure. 

The  system  of  culture  is  also  of  importance,  for  at  the  present  day, 
even  with  the  use  of  artificial  manures,  cropping  would  rapidly  im- 
poverish   soils   which    w-ere    not    suitably    and    snfiiciently    enriched. 


16  OSSEOUS   CACHEXIA. 

Abundance  or  apparent  richness  of  food  signifies  nothing  if  quaUty  is 
lacking. 

It  may  also  be  asked  :  if  the  question  of  nourishment  is  of  such  prime 
importance  why  are  animals  of  European  origin  in  Cochin-China 
aftected,  whilst  the  indigenous  races  prove  immune?  The  answer 
would  ajDpear  to  be  that,  in  addition  to  the  defective  quality  of  food, 
other  factors,  such  as  adaptation  to  environment  and  relative  digestive 
power,  play  a  considerable  part  in  the  production  of  the  disease. 

Favouring  causes.  Whilst  conceding  that  the  disease  is  due  to  one 
determining  cause,  viz.  the  food,  it  is  unquestionable  that  other  causes 
may  favour  its  appearance.  Abundant  milking  is  one,  so  that  the 
disease  most  frequently  appears  six  to  eight  weeks  after  calving.  Gesta- 
tion may  also  determine  an  attack.  The  disease  is  rarer  in  oxen  than  in 
milch  cows.  Starvation  and  bad  hygienic  conditions  also  have  a  certain 
influence ;  it  is  well  known  that  during  dry  years,  particularly  when 
fodder  is  scarce,  osseous  cachexia  makes  the  greatest  ravages.  Law 
states  that  the  disease  has  been  attributed  to  excess  of  organic  matter  in 
the  soil,  to  succulent  watery  foods,  as  rank  watery  grasses,  potatoes, 
turnips  and  other  roots  deficient  in  nutritious  solids.  Some  agent — 
microbe  or  toxin — swallowed  with  the  food  has  been  suspected  but  not 
yet  isolated. 

Other  explanations  have  been  advanced  but  up  to  the  present  time 
they  scarcely  deserve  to  be  regarded  even  as  hypotheses.  Thus  Anacker 
in  1865  declared  that  the  disease  commenced  as  muscular  rheumatism, 
was  succeeded  by  destructive  or  atrophic  ostitis,  and  ended  as  osteo- 
porosis. So  far  as  the  order  of  the  osseous  lesions  is  concerned,  this 
view  is  quite  correct,  but  the  ossific  changes  are  consequences  and  not 
causes. 

The  idea  that  the  disease  was  due  to  nn  infectious  agent  has  been 
advocated  by  Leclainche,  without,  however,  having  been  proved. 
Petrone  is  the  only  person  who  has  hitherto  suggested  that  osteo- 
malacia in  man  is  due  to  infection  with  a  nitric  ferment  {Micrococcus 
nitnficans).  According  to  him,  pure  cultures  of  this  organism  injected 
into  dogs,  produce  osteomalacia.  These  statements,  however,  require 
confirmation. 

Lesions.  The  chief  lesions  are  to  be  found  in  the  bones.  They 
consist  in  rarefaction  of  the  compact  tissue,  increase  in  size  of  the 
medullary  cavity  and  Haversian  canals,  and  enlargement  of  the  areola 
of  the  spongy  tissue.  The  bone  marrow  loses  its  fatty  constituents, 
appears  red  and  gelatinous,  and  contains  a  greatly  exaggerated  number 
of  blood-vessels.  When  heated,  the  bones  do  not  yield  oil  as  in  healthy 
subjects,  and  when  dry,  they  seem  abnormally  porous.  In  the  osteo- 
clastic phase,  the  bones  become  very  friable  and  even  the  shafts  assume 


OSSEOUS   CACHEXIA. 


17 


a  si^ongy  appearance.  They  diminish  in  density.  These  changes 
correspond  to  the  stages  of  eccentric  rarefying  ostitis  and  osteoporosis 
of  German  authors. 

The  flat  bones  often  show  well-marked  periostitis,  but  the  great 
thickening  sometimes  seen  in  certain  of  the  bones  of  the  head  appears 
to  be  the  result  of  a  special  osteo-periostitis.  It  is  quite  certain  that 
the  disease  is  due  to  something  more  than  a  mere  want  of  mineral 
constituents  in  the  bone,  and  poverty  in  this  respect  certainly  does 
not  explain  the  hj^pertrophic  changes.  The  nutrition  of  the  bones  as 
a  whole  is  disturbed,  resulting  in  alterations  both  in   the  ossein  and 


Fig.  8. — Transverse  section  through  the  middle  region  of  the  face  in  a  pig 
suffering  from  osseous  cachexia. 


in  the  mineral  salts,  the  whole  process  being  accompanied  by  symptoms 
of  osteo-periostitis. 

The  fractures  which  occur  so  frequently  during  the  osteoclastic  phase 
have  well-marked  peculiarities.  The  extravasation  of  blood  is  trifling, 
and  no  callus  forms,  even  when  the  ends  of  the  bones  are  immobilised 
by  external  aid  ;  if  the  ends  are  left  free,  they  soon  become  worn  and 
polished  by  rubbing  against  one  another. 

In  the  neighbourhood  of  the  articulations  and  ligamentous  insertions 
the  periosteum  soon  undergoes  change,  and  it  is  not  uncommon  to  find 
sub-periosteal  and  intra-osseous  extravasations  of  blood. 

Germain  has  also  noted  in  horses  the  disappearance  of  the  interver- 
tebral and  articular  cartilages,  and  the  frequent  occurrence  of  anchylosis, 
true  or  false. 

D.C.  C 


18  OSSEOUS  CACHEXIA. 

In  the  final  stages,  the  bones  may  be  cut  with  a  knife,  and  a  time 
arrives  when  bony  tissue  seems  completely  to  have  disappeared ;  thus,  as 
shown  in  Fig.  8  herewith,  it  was  possible  to  cut  the  entire  head  of  a  pig 
into  thin  slices  without  the  slightest  difficulty.  All  parts  of  the  head  had 
been  aftected  by  the  softening  change. 

From  the  chemical  point  of  view,  the  diminution  in  mineral  salts  and 
in  phosphate  of  calcium  has  long  been  recognised,  but  the  degree  of  this 
change  varies  according  to  the  phase.  In  human  beings  the  proportions 
have  been  estimated  as  follows:  Normal  bone,  50  to  80  per  cent,  of 
phosphate  of  calcium  ;  bone  in  persons  suffering  from  osteomalacia,  5 
to  20  per  cent,  of  phosphate  of  calcium.  The  changes  in  the  ossein 
have  not  been  carefully  studied.  We  only  know  that  histologically  the 
ossein  becomes  fibrillar,  and  that  chemically  it  no  longer  retains  its 
normal  comi^osition. 

The  diagnosis  is  difficult,  particularly  on  the  first  occasion  of  seeing 
the  disease,  and  especially  if  this  is  of  an  enzootic  character.  The 
practitioner  may  also  have  some  hesitation  in  diagnosing  isolated  cases 
in  regions  where  the  disease  seldom  occurs. 

Otherwise,  diagnosis  is  usually  easy,  as  soon  as  lameness  or  synovitis, 
or  arthritis  of  the  lower  regions  of  the  limbs  appears.  Only  in  isolated 
cases  are  the  lesions  likely  to  be  mistaken  for  accidental  injuries,  and  it 
is  also  fairly  easy  to  differentiate  them  from  the  localised  lesions  of 
rheumatism.  The  latter  disease  seems  more  frequently  to  attack  the 
upper  joints  of  the  limbs,  and  is  often  accompanied  by  intense  fever  and 
cardiac  disturbance. 

Prognosis.  In  a  general  sense  the  disease  is  very  grave,  because  it 
appears  as  an  enzootic,  and,  in  dry  years  and  those  during  which  there 
is  a  scarcity  of  forage,  inflicts  enormous  losses  on  the  breeders  of  certain 
countries.  When  advice  is  sought  towards  the  end  of  the  second  phase 
of  the  disease  the  prognosis  is  therefore  very  grave.  Under  such  cir- 
cumstances it  is  often  better  to  slaughter  rather  than  to  treat,  provided 
that  the  affected  animals,  like  cows,  pigs,  or  goats  are  still  of  some  value. 

The  prognosis  is  much  more  hopeful  if  treatment  is  attempted  at  an 
early  stage,  when  improved  diet  and  the  use  of  suitable  drugs  sometimes 
lead  to  recover}'. 

Treatment.  We  know  that  in  the  Middle  Ages  this  disease  was  often 
treated  1)}^  the  administration  of  crushed  bones,  and  even  at  the  present 
day  ground  bones  are  frequently  recommended.  Treatment  must  be 
subordinated  to  proper  feeding,  no  system  of  medication  being  of  any 
value  whatever  unless  the  food  is  suitable. 

Germain  states  that  imported  horses  in  Cochin-China  recover  if 
simply  returned  to  their  former  diet,  i.e.  to  cereals  and  forage  obtained 
from  France  or  Algeria.     Cantiget  shows  that  such  improvements  in 


OSSEOUS   CACHEXIA.  19 

cultivation  as  the  free  distribution  of  superphosphate  manures  on 
impoverished  soils  modify  the  chemical  composition  of  the  forage, 
and  render  it  capable  of  building  up  and  sustaining  the  organism  and 
bony  tissues  ;  treatment  should  therefore  be  essentially  prophylactic 
in  character. 

Animals  suffering  from  osseous  cachexia  should  be  fed  on  cereals  and 
forage  obtained  from  rich  districts  where  the  disease  has  never  occurred ; 
but,  as  in  times  of  scarcity  questions  of  expense  almost  always  receive 
first  consideration,  it  may  be  necessary  to  substitute  bran  for  such 
products,  or  give  oats,  maize,  beans,  rice,  and  oil  or  cotton  cake,  etc., 
all  of  which  can  be  obtained  commercially,  and  are  of  sufficient 
nutritive  richness.  It  is  often  advantageous  to  give  such  food  cooked 
and  slightly  salted. 

Commercial  ground  bones  and  calcium  phosphate  (bi-  or  tri-  basic),  in 
doses  of  1  ounce  per  day  for  oxen  and  1^  to  2  drachms  for  pigs  or  goats, 
have  given  excellent  results  in  the  hands  of  most  practitioners.  Some 
recommend  the  addition  of  iron  salts  or  bitter  tonics  like  gentian  or 
nux  vomica  in  doses  of  2^  drachms  per  day  for  a  full-grown  ox. 

Law  declares  that  the  treatment  should  be  varied  "  with  the  pre- 
dominance of  the  causes,  essential  or  accessory.  .  .  .  Green  clover, 
alfalfa,  and  other  leguminous  products,  ground  oats,  beans,  peas, 
linseed  or  rape  cake  .  .  .  and  vetches  may  be  especially  recom- 
mended. .  .  .  The  free  access  to  common  salt  and  a  liberal  supply 
of  bone  meal  are  helpful.  .  .  .  Apomorphia  is  especially  valuable  in 
correcting  the  perverted  appetite  and  stimulating  digestion.  A  change 
of  pasture  is  always  advisable.  In  all  cases  where  possible  the  water 
should  be  changed  as  well  as  the  food.  Attention  to  the  housing, 
grooming,  and  general  care  of  the  animals  should  not  be  neglected. 
Finally,  every  drain  upon  the  system  should  be  lessened  or  stopped. 
The  milk  may  be  dried  up,  and  the  animal  should  not  be  bred." 

Meat  meal  also  renders  good  service,  but  the  use  of  cod  liver  oil, 
suggested  by  Zundel,  is  too  expensive,  and  phosphorised  oil  is  too 
dangerous  to  be  adopted  in  ordinary  treatment. 

Local  treatment  for  synovitis  and  arthritis  has  been  recommended. 
It  is  ineffective  unless  accompanied  by  good  feeding  and  internal 
medication.  On  the  other  hand,  the  lesions  often  diminish  rapidly  or 
totally  disappear  under  the  influence  of  general  medication  alone. 


c  2 


20  FRACTURES. 

LOCAL  AFFECTIONS. 

FRACTURES. 

Although  oxen,  sheep,  goats,  and  pigs  are  much  less  siihject  to 
fractures  than  the  horse  and  dog,  nevertheless,  they  do  suffer  from 
such  accidents.  Eepair  is  perfectly  possible,  but  the  cases  are  often  not 
worth  treating,  unless  the  subjects  are  young  or  of  considerable  value. 
On  the  other  hand,  in  fat  and  heavy  subjects,  it  is  difficult  to  fix  the 
parts  in  position.  Slinging  produces  l)ad  results,  and  generally  should 
not  be  encouraged. 

Apart  from  fractures  accompanying  general  chronic  diseases,  like 
rachitis  and  osseous  cachexia,  the  vertebra,  the  pelvis,  the  ribs,  or  any 
of  the  limb  bones,  may  be  fractured  in  consequence  of  accident. 

Such  fractures  may  be  either  complete  or  incomplete  (fissures), 
simple  or  compound. 

The  general  signs  which  indicate  fracture  are  always  the  same,  viz., 
loss  of  function,  local  pain,  abnormal  mobility,  crepitation,  due  to  rubbing 
together  of  the  ends  of  the  bones,  and  deformity  of  the  part.  Diagnosis 
is  generally  easy ;  i^rognosis  on  the  other  hand  is  very  variable. 

The  vertebral  column  may  be  accidentally  fractured  in  the  region  of 
the  neck  in  consequence  of  the  animal  falling  on  its  head  ;  in  the  dorso- 
lumbar  region,  from  falling  into  ditches  or  ravines,  or,  in  the  case  of 
bulls  fighting,  from  violent  muscular  efforts.  Fractures  of  the  first 
kind  are  immediately  fatal ;  those  of  the  second  result  in  paraplegia 
of  the  hind  limbs,  and  necessitate  immediate  slaughter. 

Fractures  of  the  pelvis  comprise  :— 

1.  Fractures  of  the  angle  of  the  haunch,  resulting  from  external 
violence  and  characterised  by  sinking  of  the  external  angle  of  the 
ilium,  deformity  of  the  hip,  and  lameness  without  specially  marked 
characters.  This  fracture  is  rarely  complicated.  The  symptoms  of 
lameness  diminish  with  rest,  but  deformity  continues. 

2.  Fractures  of  the  floor  of  the  pelvis,  usually  extending  from  the 
anterior  margin  of  the  pubis  to  the  foramen  ovale  and  from  the 
posterior  margin  of  the  foramen  ovale  to  the  end  of  the  symphysis. 
They  result  from  obstetrical  manipulation,  as  in  forcibly  removing  a 
foetus  which  is  too  large,  or  a  monstrosity.  As  a  rule,  the  animals 
cannot  rise,  or  if  they  succeed  in  doing  so,  are  incapable  of  moving. 
Diagnosis  is  made  by  exploration  through  the  rectum.  Such  fractures 
always  necessitate  slaughter. 

Fractures  of  the  neck  of  the  ilium  and  of  the  base  of  the  cotyloid 
cavity,  even  in  cases  of  dislocation,  are  rare  despite  what  has  been 
said  to  the  contrary. 


FRACTURES.  21 

In  the  fore  limb,  fractures  of  the  scapula  and  humerus  are  usually 
of  traumatic  origin,  are  seldom  accompanied  by  marked  displacement, 
and  are  capable  of  uniting  if  a  long  rest  at  grass  is  allowed.  Pitch 
bandages  should  be  applied  to  the  surface,  covering  all  the  surrounding 
regions,  viz.  the  withers,  ujjper  portion  of  the  forearm,  girth  and  chest, 
to  assist  in  immobilising  the  region  of  fracture,  and  to  promote  union. 

Fractures  of  the  forearm  are  more  difficult  to  treat,  because  the 
bandage  applied  must  extend  as  far  as  the  hoof.  In  this  case  displace- 
ment often  occurs.  It  is  therefore  necessary,  firstly,  to  reduce  the 
fracture,  and  bring  the  ends  in  perfect  contact,  for  which  purpose  it 
may  be  requisite  to  cast  the  animal,  and  give  an  anEesthetic;  and, 
secondly,  to  apply  a  pitch  plaster  in  the  form  of  a  shallow  gutter,  leaving 
the  inner  surface  of  the  limb  uncovered  along  a  line  about  two  inches 
wide  following  the  course  of  the  veins  of  the  forearm. 

Fractures  of  the  metacarpus  and  metatarsus  usually  heal  well  in  all 
animals  of  moderate  weight,  such  as  heifers,  steers,  goats  or  sheep, 
provided  a  simple  plaster  bandage,  covering  the  entire  limb  or  prefer- 
ably with  an  opening  in  the  position  above  indicated,  is  applied  and 
continued  downwards  as  far  as  the  claws. 

In  sheep  and  goats  it  is  sometimes  even  sufficient  to  use  a  splint 
formed  of  straw-boards,  and  in  the  case  of  oxen,  of  wood,  applied  over  a 
cotton-wool  padding  and  retained  in  position  by  straps,  or  in  the  case 
of  the  heavier  animals  by  dextrine  or  pitch  bandages. 

In  the  hind  limb,  fractures  of  the  femur  are  more  serious,  because  the 
apparatus  that  can  be  used  to  secure  immobility  is  seldom  or  never 
effective ;  excepting  in  young  animals,  it  is  therefore  usually  better  to 
slaughter. 

Fractures  of  the  tibia  are  treated  like  those  of  the  forearm  when  it 
appears  desirable  to  keep  the  animals  alive. 

Plaster  bandages  can  very  easily  be  prepared  by  saturating  tarlatan 
in  a  mixture  of  equal  parts  of  thoroughly  dry  plaster  and  water.  Six  to 
ten  thicknesses  of  tarlatan,  arranged  alternately  longitudinally  and 
transversely,  are  sufficient.  When  adjusted  they  can  be  kept  in  position 
until  the  plaster  has  hardened  by  means  of  dry  bandages  applied  from 
below  upwards,  which  can  be  removed  after  a  lapse  of  half  an  hour  to 
an  hour. 

FRACTURES    OF     THE    HORNS. 

Anatomy  of  the  horns.  The  horns  form  organs  of  defence,  and 
project  on  either  side  of  the  frontal  bone  at  the  poll.  Each  consists 
firstly  of  a  bony  basis  generally  known  as  the  horn  core  ;  secondly,  of  a 
horn-secreting  membrane ;  thirdly,  of  a  horny  sheath,  the  horn  properly 
so  called. 


22 


FRACTURES. 


(1.)  The  horn  core  projecting  from  the  frontal  bone  does  not 
develop  until  after  birth.  About  the  third  month  a  little  prominence 
appears  under  the  skin,  which,  as  it  develops,  assumes  a  conical' shape, 
and  may  be  seen  to  be  covered  with  a  horny  substance.  In  proportion 
as  the  horn  core  grows,  there  develops  within  it  a  cavity  which  may 
either  be  of  a  simple  character  or  divided  by  a  longitudinal  partition. 
This  communicates  with  the  frontal  sinus,  a  fact  which  explains  the 
collection  of  pus  in  the  sinuses  as  a  result  of  injuries  to  the  horns. 
The  sin  as  of  the  horn  core  does  not  exist  in  young  animals,  and  is  not 
completely  developed  before  the  third  or  fourth  year  of  life. 

(2.)  The  horn-secreting  membrane  is  formed  by  the  skin,  which  under- 
goes special  development  around  the  base  of  the  horn  and  comes  to 


Fig. 


-C,  horn  ;  P,  modified  skin  forming  the  keratogenous  membrane  ; 
0,  liorn  core,  exhibiting  a  double  sinus. 


resemble  that  of  the  coronary  band,  from  which  the  hoof  or  claw  is 
secreted.  The  band  is  about  one-fifth  of  an  inch  in  breadth.  The 
papillae  of  the  dermis  are  specially  developed  at  this  point,  and  the 
epithelium  which  they  secrete  eventually  forms  the  horn. 

The  internal  surface  of  the  growing  horn  is  adherent  to  the  horn  core 
through  the  medium  of  another  tissue  formed  by  a  specially  differentiated 
periosteum  which  is  continuous  with  the  periosteum  covering  the  frontal 
bone.  It  is  not  a  true  periosteum,  but  a  vascular  tissue  formed  of  papillary 
layers  analogous  to  those  of  the  podophyllous  tissue  of  the  ox's  claw  or 
horse's  hoof. 

This  keratogenous  membrane  receives  a  rich  vascular  supply  from 
the  arterial  circle  formed  at  the  base  of  the  horn  core  by  a  division 
of  the  external  carotid,  the  blood  conveyed  by  which  is  freely  distri- 
buted to  the  enlarged  papillae.     The  great  vascularity  of  these  parts 


FRACTURES.  23 

explains  why  lesions  of  the  horns  are  often  follo\Yed  by  such  profuse 
bleeding. 

(3.)- The  horn  secreted  by  the  papillcB  of  the  horn  band  (which  is 
analogous  to  that  of  the  coronary  band  of  the  horse)  forms  a  cone 
varying  in  its  curve  in  various  breeds.  Its  base  is  hollow,  and 
contains  little  depressions  holding  the  papilla  from  which  the  horn  is 
secreted.  From  its  base  up  to  the  end  of  the  horn  core  the  walls  pro- 
gressively increase  in  thickness.  From  this  point  it  is  solid ;  in  a 
fully-grown  horn  the  bone  does  not  extend  more  than  one-half  or 
two-thirds  of  the  entire  length. 

In  the  adult,  the  development  of  the  horns  varies  with  different 
breeds  and  is  affected  by  sex.  In  the  bull  the  horns  are  short,  but  in 
the  cow  and  ox  long.  Short  and  fine  in  animals  of  improved  breed  like 
the  Durham,  they  are  long  and  thick  in  breeds  of  working  oxen. 

Injuries  affecting  the  horns  are  of  three  classes,  determined  by  the 
part  affected. 

1.  Detachment  of  the  horn  or  sheath. 

2.  Laceration : — 

(a)  Of  the  horny  sheath  alone. 

(/>)  Of  the  horny  sheath  and  of  the  horn  core. 

(c)  Of  the  horn  core  alone,  the  horny  sheath  remaining  intact. 

3.  Fractures  :  — 

(a)  Of  the  terminal  half  of  the  horn. 
(h)  Of  the  lower  half. 
{c)  Of  the  base. 

DETACHMENT    OF    THE    HORNS. 

When  the  3'oke  is  badly  fitted  or  padded,  it  is  liable  to  cause  a 
continual  strain  or  a  succession  of  shocks  producing  chronic  inflam- 
mation of  the  keratogenous  membrane.  Should  the  end  of  the  horn 
then  be  struck  heavily,  it  is  quite  possible  that  the  horn  will  either 
partially  or  wholly  be  detached.  In  this  case  it  falls  away  without  there 
necessarily  being  any  important  lesion  of  the  horn  core. 

Such  accidents  are  not  infrequently  caused  by  the  driver  striking  the 
ox  on  the  horn  with  the  yoke  in  order  to  keep  it  quiet  while  it  is  being 
harnessed. 

The  prognosis  of  this  condition  is  not  grave,  except  for  the  fact 
that  working  animals  cannot  be  used  until  the  horn  is  completely 
regrown. 

The  treatment  simply  consists  in  thoroughly  cleansing  and  disin- 
fecting the  horn  core  and  then  applying  a  protective  dressing.  The 
bony  basis  is  surrounded  with  a  mass  of  tow  saturated  with  an  antiseptic 


24  FISSURINC    OF   THE   HORNS. 

solution,  like  2  per  cent,  creolin  or  carbolic  acid  solution,  which  is  kept 
in  position  by  a  spiral  bandage  passed  around  the  horn,  and  secured  in 
a  figure  of  8  on  the  opposite  horn.  Instead  of  applying  such  a  dressing, 
some  practitioners  content  themselves  with  using  an  antiseptic  ointment 
or  even  a  simple  dressing  of  tar. 


FISSURING    OF    THE    HORNS. 

Causation.  In  a  general  sense  fissures  may  result  from  any  violence 
affecting  the  centre  portion  of  the  horns,  such  as  blows  with  the  yoke 
or  accidental  bruises  inflicted  by  the  animals  themselves  in  fighting 
with  their  neighbours. 

Symptoms.  Whether  the  fissure  is  confined  to  the  horny  covering 
itself  or  whether  it  extends  to  both  the  i)ortions  constituting  the  horn, 
that  is,  the  horny  covering  and  the  horn  core,  two  very  noticeable 
symptoms  are  always  present :  1.  A  straight  fissure  resembling  a  sand 
crack,  and  appearing  usually  on  the  convexity  of  the  horn,  and,  2.  A 
very  trifling  hsemorrhage,  which  does  not  appear  until  some  hours  or 
even  a  day  after  the  accident. 

Diagnosis.  If  the  lesion  only  affects  the  horn  core,  diagnosis  is 
always  difficult,  for  one  can  hardly  perceive  any  sensitiveness  of  the  horn 
near  the  fissure. 

Prognosis.  Provided  that  the  horn  core  is  not  injured,  the  prognosis 
is  favourable ;  but  in  the  contrary  case,  it  should  be  reserved  ;  for 
haemorrhage  extending  to  the  interior  of  the  frontal  sinus  not  infrequently 
causes  suppuration  in  that  cavity. 

Treatment.  Attempts  should  first  be  made  to  check  haemorrhage  by 
applying  masses  of  tow  saturated  with  cold  water  and  frequently  wetted 
with  slightly  antiseptic  solutions,  such  as  2  per  cent,  creolin  or 
carbolic  acid.  If  haemorrhage  persists  in  spite  of  this  simple  treatment, 
astringents  may  be  employed,  which,  by  causing  the  formation  of  a  clot, 
mechanically  arrest  further  extravasation  of  blood.  These  astringents 
vary  considerably  in  value,  and  we  should  particularly  warn  practi- 
tioners against  perchloride  of  iron,  which  causes  necrosis  of  the 
tissues,  and  later,  formation  of  pus.  A  5  per  cent,  solution  of  gelatine 
is  haemostatic  and  excellent  for  the  purpose  named,  as  also  is  hydroxyl 
solution.  When  once  haemorrhage  is  arrested,  the  keratogenous  mem- 
brane rapidly  heals  in  consequence  of  its  vascularity,  and  soon  secretes 
fresh  horn. 


FRACTURES   OF   THE    HORNS. 


25 


FRACTURES    OF    THE    HORNS. 

Etiology.  Fractures  of  the  horns,  Kke  fissures,  are  produced  by 
violence,  but  of  a  more  marlced  cliaracter.  They  are  termed  complete 
or  incomplete,  according  as  the  entire  thickness  of  the  horn  or'  only  a 
portion  of  that  thickness  is  involved. 

The  fracture  may  affect  either  the  terminal  half  or  the  basilar  half ; 
or,  again,  it  may  have  its  seat  in  the  frontal  bone  below  the  origin  of  the 
horn  core,  in  which  case  a  flake  of  bone  will  be  detached.  Such  fractures 
assume  varying  forms,  and  may  either-  be  deeply  excavated,  oblique, 
smooth,  regular  or  dentated. 

Symptoms.  The  symptoms  are  extremely  simple.  They  consist 
mainly  in  the  mobility  of  the  frac- 
tured end,  and  such  phenomena 
as  sensitiveness,  haemorrhage,  etc. 
When  the  fracture  extends  to  the 
frontal  bone,  crepitation  may  also 
be  noted. 

Prognosis.  The  prognosis  is  not 
grave  unless  the  fracture  extends 
to  the  basilar  half  of  the  horn  or 
affects  the  frontal  bone. 

Treatment.  (1.)  If  the  fracture 
is  confined  to  the  horn  core,  it  is 
only  necessary  to  bring  the  frag- 
ments into  regular  apposition,  after 
having  removed  the  broken  end  of 
the  horn  itself. 

(2.)  In  treating  a  fracture  affect- 
ing the  middle  portion  of  the  horn  or  in  treating  animals  destined  for  the 
butcher,  the  best  method  is  to  make  a  simple  wound  by  dividing  the 
parts  with  a  saw  below  the  fracture.  This  is  a  painful  operation,  neces- 
sitating anaesthesia,  and  requiring  the  animal  to  be  cast  or  firmly  fixed  to 
a  post  or  placed  in  a  trevis.  To  diminish  the  painful  stage  of  the  opera- 
tion, it  was  formerly  recommended  to  make  a  circular  incision  extending 
through  the  entire  thickness  of  the  horn  proper,  and  then  to  remove 
with  a  fine,  very  sharp  saw  the  portion  of  the  horn  core.  This,  however, 
is  scarcely  practicable,  and  it  is  much  better  to  make  a  direct  section. 
Haemorrhage  is  checked  with  compresses,-  moistened  with  cold  water, 
after  which  a  dressing  known  as  the  "  Maltese  cross  dressing  "  (Fig.  10) 
is  applied  according  to  general  principles. 

The  surface  of  the  section,  after  washing  with  an  antiseptic  solution, 
is  powdered  with  iodoform  or  a  mixture  of  iodoform  and  boric  acid, 


Fig.  10.- 


-Dressiiig  for  fracture  of 
the  horn. 


FRACTURES   OF   THE   HORNS. 


covered  with  a  mass  of  tow  or  cotton  wool,  saturated  with  liquid  anti- 
septic, and  then  surrounded  with  a  flat  pad  of  wadding,  which  extends 
completely  around  the  horn  as  far  as  its  base.  A  second  pad  of  larger 
size,  intended  to  protect  the  wound  against  external  violence,  is  arranged 
around  the  free  extremit}^  of  the  horn.  This  is  kept  in  position  by  two 
small  cross  bandages.  Another  bandage,  the  loop  of  which  is  fixed  to 
the  base  of  the  opposite  horn,  is  then  applied  in  spiral  turns,  completely 
enveloping  the  former  pads  and  extending  from  the  base  to  the  point. 
Arriving  at  the  free  end,  the  operator  reverses  the  bandage,  draws  it 
tight,  and  continues  down  to  the  base  of  the  horn,  fixing  it  by  figure  of  8 
turns  passed  around  the  base  of  both  horns. 

(3.)  In  dealing  with  fractures  of  the  lower  third  of  the  horn  in  working 
oxen,  it  is  necessary  to  seek  consolidation  of  the  horn  by  callus  formation, 

so  that  the  animals  may  again 
become  useful  in  the  yoke. 
Very  great  difficulty  accom- 
panies attempts  to  immobilise 
the  horn  in  such  cases,  since 
the  least  shock  to  the  extremity 
of  the  horn  destroys  the  union, 
on  account  of  the  length  of  the 
lever  represented  by  the  horn 
itself. 

The  first  method  of  treatment 
consists,  after  the  wound  has 
been  carefully  disinfected,  in 
fixing  the  ends  in  place  by 
tightly  applied  pads,  surrounded 
These  are  supported  by  several 


Fig.  11. — S2>lint  for  fractured  horn. 


by  splints,  curved  to  fit  to  the  horn 
turns  of  a  spiral  bandage. 

Were  one  certain  of  the  cleanliness  of  the  wound  and  of  its  perfectly 
aseptic  condition,  it  would  be  better  at  once  to  have  recourse  to  a  fixed 
bandage,  strengthened  by  plaster  or  silicate  of  soda. 

These  bandages  are  applied  longitudinally  and  should  extend  a  con- 
siderable distance  on  either  side  of  the  fractures.  If  the  horn  is  long  and 
thick,  it  is  best  to  use  a  fixed  dressing  of  this  kind  secured  by  bandages 
in  the  form  of  a  Maltese  cross. 

All  these  methods,  however,  are  more  or  less  inconvenient,  and  tbe 
most  practical  procedure  often  consists  in  removing  the  horn.  Treatment 
should  only  be  attempted  when  the  owner  specially  requests  it  in  order  to 
render  the  animal  useful  for  working  or  show  purposes. 

Moreover,  however  strong  the  dressing,  accidents  are  frequent,  for 
accidental  shocks  to  the  fractured  horn  interfere  with  the  co-aptation  of 


FRACTURES   OF   THE    HORNS. 


27 


parts,  and  diminish  the  chance  of  perfect  union.     To  avoid  these  draw- 
backs, the  apparatus  shown  in  Fig.  11  has  been  invented. 

This  apparatus  consists  of  a  splint,  the  middle  of  which  fits  the  back  of 
the  animal's  poll,  the  sides  being  gouged  out  to  receive  the  lower  half  of 
the  horn  and  notched,  to  enable  the  fractured  horn  to  be  well  supported 
by  bandages. 

(4.)  Fractures  of  the  base  of  the  horn  are  more  serious,  because  a 
fragment  of  the  frontal  bone  is  usually  torn  away  with  the  horn  core. 
As  a  rule,  the  fracture  is 
subcutaneous  or  without  ex- 
ternal wound.  The  horn  is 
displaced,  and  swings  loosely. 
On  examination,  a  charac- 
teristic crepitation  sound  is 
easily  detected.  In  such  frac- 
tures haemorrhage  is  subcu- 
taneous and  often  extends  to 
the  frontal  sinus,  in  conse- 
quence of  which  it  is  not 
uncommon  for  pus  to  form 
in  the  sinus  as  a  complica- 
tion. 

Treatment  includes  reduc- 
tion of  the  fracture,  and  the 
application  of  a  fixed  plaster 
or  silicate  bandage  cover- 
ing the  fron to-occipital  and 
superior     auricular    regions. 

When  a  skin  wound  exists,  it  is  better  to  remove  the  horn  and  bony 
fragment,  and  to  apply  an  antiseptic  dressing  in  order  to  prevent  infection 
of  the  frontal  sinus. 


Fig.  12. 


-Dressing  for  fracture  of  the  base 
of  the  horn. 


EXOSTOSES, 

SPAVIN    IN    THE  ;OX. 

Exostoses  are  somewhat  uncommon  in  the  bovine  species,  and  when 
they  occur  are  rarely  of  great  clinical  interest.  Nevertheless,  in  cows 
and  old  working  ^' oxen  one  sometimes  sees  metatarsal  spavin.  Its 
gravit}^  however,  appears  to  be  very  much  less  than  in  the  horse,  on 
account  of  its  position.     Very  commonly  there  is  only  trifling  lameness. 

Treatment  by  application  of  biniodide  of  mercury  ointment  or  the 
actual  cautery  gives  good  results.  The  principal  precaution  required  is 
to  prevent  the  animals  licking  the  parts. 


28 


RING-BONE. 


RING-BONE. 


Ring-bones  only  occur  in  working  oxen,  and  particularly  in  aged 
animals  used  in  hilly  regions.  They  result  almost  exclusively  from 
wounds,  ligamentous  and  tendinous  strains,  and  articular  injuries. 

They  are  preceded  (as  can  usually  be  proved  by  dissection  of  limbs)  by 


Fig.  13. — Tibia.     Lesions  due  to  open  fracture  and  displacement.     Irregular 
callus  formation  and  seenestrum. 


fibrous  or  fibro-cartilaginous  induration  in  or  about  the  coronet  or  one 
of  the  phalanges.  These  thickenings  increase  the  diameter  of  the 
pastern  in  all  directions.    Ring-bones  are  seldom  very  large  ;  but  as  they 


SUPPURATING   OSTITIS. 


29 


partially  or  entirely  surround  the  insertions  of  the  lateral  ligaments, 
inter-phalangeal  articulations  or  insertions  of  the  digital  extensors,  they 
are  painful,  and  produce  lameness  of  varying  intensity. 

Diagnosis  is  easy,  partly  because  the  tension  of  the  skin  and  the 
fibrous  thickening  render  palpation  painful. 

Prognosis  is  grave,  because  the  effect  of  ring-bone  is  sometimes  to 
render  working  animals  useless. 

Treatment.  To  relieve  the  diseased  claw  of  pressure  due  to  its  bearing 
on  the  ground,  the  shoe  should  be  removed  and  the  claw  freely  pared. 


Fig.  14. — Sarcoma  of  the  periosteum 
beneath  the  scapula. 


Fig.   15. — Sarcoma  of  the  periosteum 
covering  the  upper  end  of  the  tibia. 


If  necessary,  the  healthy  claw  of  the  same  foot  may  be  raised  by  placing 
a  piece  of  thick  leather  between  the  sole  and  the  shoe.  It  is  advisable  at 
once  to  apply  an  energetic  plaster,  or,  better  still,  to  resort  to  firing  in 
points. 

SUPPURATING    OSTITIS. 
In  addition  to  the  changes  in  bone  resulting  from  rachitis,  osseous 
cachexia,  tuberculosis,  and  actinomycosis,  one  sometimes  sees  cases  of 
periostitis  or  ostitis  pure  and  simple.     As  a  result  of  external  injury  or 


30  BONE   TUMOURS. 

direct  wounds,  the  bone  may  be  contused  and  injured,  becoming  the  seat 
of  diffused  periostitis,  necrosis,  suppurating  ostitis  or  osteomyelitis. 
Open   fractures   may  produce  the  same  results. 

Treatment  comprises  disinfection  of  wounds,  antiseptic  injection  of 
fistulfe,  the  application  of  antiseptic  pencils,  curettage,  the  removal  of 
sequestra,  and  vesicant  or  resolvent  complications.  When  such  condi- 
tions extend  to  neighbouring  joints  and  produce  suppurative  arthritis, 
the  animals  oudit  to  be  killed. 


BONE    TUMOURS. 

The  only  bone  tumours  of  real  importance  from  a  practical  point  of 
view  are  malignant  growths  represented  by  rapidly  spreading  epithelio- 
mata  or  sarcomata,  originating  in  the  periosteum.  Fortunately  such 
tumours  are  rare. 

They  are  not  difficult  to  diagnose,  as  they  develop  rapidly,  are  accom- 
panied by  pain  and  lameness  ending  in  diminution  or  loss  of  the  power 
of  movement,  and  frequently  attack  neighbouring  lymphatic  glands. 
Even  when  in  good  condition,  animals  lose  flesh  and  appetite,  and  finally 
die  of  general  wasting.  The  diagnosis  is  sufficiently  guided  by  the 
deformity  of  the  parts,  the  bosselated  appearance  of  the  tumours,  the 
absence  of  fluctuation,  the  haemorrhage  which  follows  exploratory  punc- 
ture, the  character  of  the  little  fragments  of  tissue  removed  through 
these  punctures,  and  finally  the  leukocytosis,  which  accompanies  the 
development  of  malignant  tumours. 

The  prognosis  is  grave,  for  it  is  usually  difficult  or  out  of  the  question 
to  have  recourse  to  removal,  resection  or  amputation,  when  the  tumours 
have  acquired  any  considerable  size.  Success  is  impossible  unless 
intervention  is  early,  and  the  growth  is  in  a  readily  accessible  part.  In 
other  circumstances  early  slaughter  is  indicated. 


CHAPTER    II. 
DISEASES    OF    THE    FOOT. 

CONGESTION  OF  THE  CLAWS. 

Congestion  of  the  cla^vs  is  not  infrequently  confused  with  contusion  of 
the  sole.  It  is,  however,  essentially  different,  and  presents  closer 
analogies  with  laminitis.  The  condition  is  characterised  by  congestion  of 
the  entire  vascular  system  of  the  claw  and  principally  of  the  velvety 
tissue.  Like  laminitis,  it  affects  all  four  limbs  ;  in  rare  cases  the  two 
front  or  two  hind. 

Congestion  of  the  claw  results  almost  exclusively  from  enforced  move- 
ment on  hard,  dry  and  hot  ground.  It  is  commoner  in  animals 
unaccustomed  to  walking,  and  in  heavy  beasts  which  have  been  travelled 
considerable  distances  to  attend  fairs  or  markets.  It  is  commonest  in 
the  bovine  and  porcine  species,  and  less  common  in  sheep. 

The  symptoms  appear  after  animals  return  from  a  long  journey  by 
road.  They  are  characterised  by  unwillingness  to  bear  weight  on  the 
feet  and  ditiiculty  in  movement.  Standing  is  painful,  and  the  animals 
resist  being  moved;  as  soon  as  released  they  lie  down. 

Diagnosis  presents  no  difficulty,  though  the  condition  is  sometimes 
mistaken  for  slight  laminitis. 

Prognosis  is  favourable. 

Absolute  and  prolonged  rest  is  always  followed  by  recovery,  no 
internal  medication  being  necessar}',  though  this  result  is  promoted  by 
enveloping  the  claws  in  wet  compresses  or  by  using  cold  foot  baths,  etc. 

CONTUSIONS    OF    THE    SOLE. 

Contusions  of  the  sole  are  only  seen  in  animals  which  work  without 
shoes  or  in  such  as  are  badly  shod. 

Work  on  rocky  ground,  movement  over  newly  metalled  roads,  and 
wounds  produced  by  sharp  stones,  are  the  principal  causes  of  contusion 
of  the  sole.  Badly  applied  shoes,  flat  or  slightly  convex  on  their  ujjjDer 
surfaces,  may  also  produce  bruising  in  the  region  of  the  sole.  The 
anterior  angle  of  the  claw  is  rarely  affected. 


32  •  CONTUSIONS   OF   THE   SOLE. 

Lameness  is  the  first  symptom  to  attract  attention.  It  is  slightly 
marked,  unless  the  bruising  has  been  overlooked  until  suppuration  has 
set  in.  It  affects  only  one  or  two  limbs,  and  is  rarely  accompanied  by 
general  disturbance,  such  as  loss  of  appetite,  fever,  exhaustion  during 
work,  etc. 

Locally  the  claw  or  claws  affected  are  abnormally  sensitive  to  per- 
cussion of  the  wall,  and  particularly  to  compression  of  the  sole. 

The  parts  are  hot  to  the  hand,  and  thinning  the  sole  with  a  knife  shows 
little  perforations,  irregular  points  and  crevices  in  the  horn.  One 
may  also  find  softening,  infiltration  and  hfemorrhage  within  the  horn 
similar  to  those  of  corn  in  the  horse,  undermining  of  the  sole  over 
limited  areas,  and  sometimes  suppuration,  if  the  animals  have  been 
forced  to  work  when  lame. 

Complications  like  necrosis  of  the  velvety  tissue  or  of  the  bone,  though 
comparatively  common  in  the  horse,  are  rare  in  oxen. 

Diagnosis  is  not  difficult  provided  the  history  of  the  case  is  known. 
Confusion  with  laminitis  is  scarcely  possible,  for  the  gait  of  this  lameness 
and  the  local  symptoms  are  all  different.  Examination  of  the  sole  will 
usually  dispel  any  remaining  doulit. 

Prognosis.  The  prognosis  is  favourable.  When  the  horn  is  simply 
softened  and  a  blackish  liquid  transudes,  the  lesion  is  trifiing;  if  the 
discharge  is  reddish  grey  the  lesion  is  graver,  and  implicates  all  the 
velvety  tissue ;  finally,  separation  of  the  horn  from  the  secreting 
membrane  and  the  discharge  of  true  pus  point  to  death  of  the 
keratogenous  tissue  or  of  the  bone. 

Treatment  should  be  commenced  by  carefully  thinning  the  sole 
around  the  wound  and  applying  moist  antiseptic  dressings  or  cold 
affusions.  Eemoval  of  loose  portions  of  horn  hastens  repair  by  allowing 
discharge,  which  has  accumulated  between  the  living  tissues  and  the  horn 
itself,  to  escape  freely.  The  extirpation  of  necrotic  tissue  and  the  appli- 
cation of  surgical  dressings  are  only  called  for  in  specially  grave  cases. 

This  treatment  usually  gives  good  results.  The  acute  complications 
which  are  so  common  and  so  dangerous  in  the  horse  seldom  occur  in 
the  ox. 

Most  of  these  operations  can  be  performed  without  casting,  provided 
the  animal  is  placed  in  a  trevis  or  is  sufficiently  secured. 

LAMINITIS. 
Laminitis    is    characterised    by    congestion,    followed    by    inflam- 
mation of  the  horn- secreting   tissues  of    the  foot.     It  is  now  rare  in 
oxen  and  very  seldom  assumes  an  acute  form.     'J'he  slow  pace  at  which 
animals  of  the  bovine  species  move  may  sufficiently  explain  this  rarity ; 


LAMINITIS.  33 

nevertheless,  prolonged  travel  on  stony  roads  with  heavy  vehicles,  rapid 
and  repeated  marches  to  towns  or  imj)ortant  fairs,  are  sufficient  to  pro- 
duce attacks.  Before  the  days  of  railways,  and  for  some  time  after 
their  introduction,  in  Britain  cattle  were  travelled  by  road,  and  laminitis 
was  common. 

Long  journej's  in  crowded  railway  trucks  may  also  produce  the  disease, 
although  the  animal  has  not  been  forced  to  walk.  Persons  engaged  in 
exhibiting  cattle  at  shows  are  well  aware  of  this.  Prolonged  main- 
tenance of  the  standing  position  will  produce  the  trouble,  to  which 
the  joltings  of  the  railway  journey  may  also  contribute  their  share. 
Prolonged  standing  on  board  ship  may  induce  laminitis, 

"  Show  condition  "  and  the  consumption  of  highly  nitrogenous,  and 
particularly  of  farinaceous,  foods  favour  the  occurrence  of  laminitis. 

Breed  is  also  considered  to  have  some  influence,  and  laminitis  is  said 
to  occur  more  frequently  in  animals  raised  in  flat  districts,  because  in  their 
case  the  space  between  the  digits  is  larger  than  in  mountain-bred  cattle. 
In  this  connection  the  body  weight  may  perhaps  play  a  certain  part. 

The  symptoms  vary  somewhat,  depending  on  whether  laminitis  is 
general  and  aft'ects  all  four  feet,  or  restricted  to  the  two  front  or  the  two 
hind  feet. 

The  internal  claws  always  seem  more  severely  affected  and  more  sensi- 
tive than  the  external.  In  very  rare  cases  the  animal  remains  standing, 
l)ut  usually  it  lies  down,  and  will  only  rise  under  strong  compulsion. 

When  standing,  the  symptoms  are  similar  to  those  noted  in  the  horse  ; 
the  animal  ajDpears  as  though  absolutely  incapable  of  moving.  If  all 
four  feet  are  afi'ected  the  animal  assumes  a  position  as  though  just  about 
to  rise  ;  if  the  front  feet  alone  are  affected  the  animal  kneels  in  front 
whilst  it  stands  on  its  hind  legs,  a  very  unusual  position  for  the  ox  to 
assume ;  Anally,  if  the  hind  feet  alone  are  affected,  the  animal  seems  to 
prefer  a  position  with  the  feet  under  the  body  both  in  front  and  behind. 
(See  Veterinarian,  1894,  case  by  Bayley,  and  note  by  Nunn.) 

It  is  always  difficult  to  make  the  animal  move.  Walking  seems  pain- 
ful, and  most  weight  is  thrown  on  the  heels.  The  body  swings  from 
side  to  side  as  the  limbs  are  advanced,  and  each  limb  is  moved  with  a 
kind  of  general  bodily  effort. 

The  claws  are  hot,  sensitive  to  the  slightest  touch,  and  painful  on 
percussion. 

Throughout  the  development  of  laminitis  the  general  symptoms  are 
very  marked.  The  appetite  falls  off"  early,  fever  soon  appears,  and  in 
grave  cases  the  temperature  rises  to  105"^  or  to  106°  Fahr.  Thirst  is 
marked,  and  the  animal  seems  to  prefer  cold  drinks.  The  muzzle  is  dry, 
the  face  anxious  and  expressive  of  pain.     Wasting  is  rapid. 

The  ordinary  termination  is  in  resolution,  which  occurs  between  the 

D.C.  D 


34  DISEASES   OF   THE    FOOT. 

eighth  and  fifteenth  day,  provided  the  patient  has  been  suitably  treated. 
The  disease  rarely  becomes  chronic.  On  the  other  hand,  the  claw  occa- 
sionally separates,  as  a  consequence  of  haemorrhage  or  suppuration, 
between  the  horn  proper  and  its  secreting  membrane.  Should  this 
comi)lication  threaten,  the  pastern  becomes  greatly  swollen,  the  ex- 
tremities become  intensely  congested,  and  separation  commences  at 
the  coronet.     Loss  of  the  claws,  however,  like  suppuration,  is  rare. 

Diagnosis.  Congestion  of  the  sole,  the  early  stage  of  infectious 
rheumatism  and  osseous  cachexia  may,  at  certain  periods  of  their 
development,  be  confused  with  laminitis ;  but  the  history'  and  the 
method  of  development  of  the  above-mentioned  diseases  always  allow 
of  easy  differentiation. 

It  should,  however,  be  added  that,  in  certain  exceptional  conditions 
(suppurating  echinococosis,  producing  chronic  intoxication,  tumours 
of  the  liver,  and  tumours  of  the  pericardium  and  mediastinum), 
symptoms  may  be  shown  that  suggest  the  existence  of  laminitis, 
although  it  is  not  really  present.  In  these  cases  pain  ma}'  possibl}^  be 
felt  in  the  bones  of  the  extremities. 

The  prognosis  is  usually  favourable,  but  necessarily  depends  on  the 
intensity  of  the  disease.     Fat  stock  always  suffer  severely. 

The  treatment  varies  in  no  important  particular  from  that  prescribed 
for  the  horse,  and  is  usually  followed  by  rapid  improvement.  The  chief 
indications  are  free  bleeding  from  the  jugular,  the  application  of  a 
mustard  plaster  over  the  chest,  and  the  administration  of  a  smart  purga- 
tive (1  to  2  lbs.  of  sulphate  of  soda,  according  to  the  size  of  the  animal) 
at  first,  followed  by  laxatives.  This  treatment  may  be  completed  by 
giving  salicylate  of  soda  ^jcr  os  in  doses  of  5  to  8  drams,  or  arecoline  in 
subcutaneous  injection,  1  to  1^  grains.  Local  treatment  consists  in  cold 
affusions  or  poultices  to  the  feet. 

Failing  cold  baths,  clay  plasters  applied  to  the  feet  are  useful.  To 
ensure  success  all  these  methods  should  be  utilised  simultaneously.  In 
cases  of  separation  of  the  claw,  antiseptic  dressings,  with  a  thick  pad  of 
tow  placed  under  the  sole,  become  necessary. 

Chronic  laminitis  may  perhaps  occur  in  the  ox  as  in  the  horse,  but,  as 
a  rule,  oxen  are  slaughtered  before  the  disease  can  assume  this  form. 
In  dealing  with  fat,  or  even  with  fairly  well-nourished,  oxen  it  would 
clearly  be  more  economical  to  slaughter  early,  and  so  prevent  wasting 
and  the  resulting  loss  from  disease. 

SAND    CRACK. 

Sand  crack — that  is  to  say,  the  occurrence  of  vertical  fissures  in  the 
Wall  of  the  claw — is  not  absolutely  rare  in  bovines.     It  is  commonest  in 


SAND   CRACK.  35 

working  oxen  drawing  heavy  loads,  though  in  very  exceptional  cases  it 
affects  animals  which  have  never  worked.  (Moussu  describes  one  case 
in  a  young  ox  where  four  sand  cracks  existed  simultaneously.)  It  may 
also  result  from  injuries  to  the  coronet.  In  contrast  to  the  case  of  the 
horse,  and  owing  to  the  different  conditions  under  which  the  ox  performs 
its  work,  the  disease  is  commoner  in  front  than  in  hind  feet.  In 
drawing,  the  ox's  front  limbs  play  the  principal  part,  and  the  animal 
pivots,  so  to  speak,  on  the  claws  of  the  front  limbs. 

The  position  of  the  crack  may  vary.  It  is  commonest  on  the  inner 
surface  of  the  claw,  rare  at  the  toe,  and  still  rarer  at  the  quarter. 
It  is  often  superficial  and  complete,  extending  throughout  the  entire 
height  of  the  claw,  but  not  throughout  its  thickness  ;  sometimes  it  is 
complete  and  profound,  the  fissure  then  extending  to  the  podophyllous 
tissue. 

The  symptoms  are  purely  local  in  the  case  of  superficial  lesions. 
When  the  injury  is  deep  seated,  or  when  it  originates  in  a  wound  of  the 
coronet,  lameness  is  present.  Intense  lameness,  swelling  of  the  coronet, 
and  blood-stained  or  purulent  discharge  point  to  grave  injury  and 
probable  complications. 

Diagnosis  is  easy.  The  prognosis  naturally  varies  with  the  symptoms. 
It  is  favourable  when  the  fissure  is  merely  superficial,  but  becomes  grave 
when  it  is  deep  seated  and  the  animal  is  exclusively  used  for  heavy 
draught. 

Treatment.  When  the  lesion  is  superficial  and  unaccompanied  by 
lameness,  no  surgical  interference  is  necessar3\  Rest  or  very  light  work 
is  alone  required.  As  soon  as  lameness  appears,  rest  is  obligatory.  The 
application  of  antiseptic  poultices,  containing  2^  to  3  per  cent,  of  carbolic 
acid,  creolin,  etc.,  usually  alleviates  pain  in  a  short  time,  and  facilitates 
healing  in  the  depth  of  the  fissure. 

In  exceptional  cases,  where  complications  have  occurred  in  conse- 
quence of  suppuration  beneath  the  fissure,  suppuration  in  the  coronary 
region,  or  necrosis  of  the  podophyllous  tissues,  an  operation  becomes 
necessary,  and  is  of  exactly  similar  character  to  that  performed  under 
like  circumstances  in  the  horse. 

Over  a  space  of  1  to  IJ  inches  on  either  side  of  the  fissure  the  horn 
is  thinned  "to  the  blood,"  and  the  subjacent  dead  tissue  removed.  The 
claw  is  then  thoroughly  cleansed  with  some  antiseptic  solution,  the 
wound  freely  dusted  with  equal  parts  of  iodoform,  tannin  and  boric 
acid,  and  covered  with  pads  of  tow  or  cotton  wool,  fixed  in  position  by 
appropriate  bandages.  After  such  operations  a  long  rest  is  essential 
for  complete  recovery,  during  which,  however,  the  animal  may  be 
fattened. 

The  object  of  operation  is   to   prevent   complications,   like   chronic 

D  2 


36  DISEASES   OF   THE    FOOT. 

suppuration  and  necrosis,  which  would  endanger  the  animal's  life,  rather 
than  to  effect  perfect  restoration  of  usefulness  for  the  work  previously 
done. 

PRICKS    AND    STABS    IN    SHOEING. 

The  wall  of  the  ox's  claw  is  so  thin  that  shoeing  is  alwa_ys  somewhat 
difficult,  more  especially  as  nails  can  only  be  inserted  in  the  external 
wall.  Moreover,  as  very  fine  nails  must  he  used,  they  are  apt  to  bend, 
penetrate  the  podophyllous  tissue,  and  cause  injuries  of  varying  import- 
ance. The  ox  is  often  very  restless  when  being  shod,  and,  even  though 
firmly  fixed,  usually  contrives  to  move  the  foot  every  time  the  nail  is 
struck.  The  farrier,  therefore,  may  easily  overlook  the  injury  which  he 
has  just  caused,  and  by  proceeding  and  ignoring  it  may  transform  a 
simple  stab  into  a  much  more  dangerous  wound. 

Symptoms.  In  most  cases  lameness  appears  immediately  the  animal 
leaves  the  trevis,  but,  although  this  is  more  difficult  to  explain,  lameness 
is  sometimes  deferred  until  the  day  after,  or  even  two  days  after,  shoeing. 
Though  little  marked  at  first,  lameness  may  become  so  severe  that  the 
animal  cannot  bear  the  pain  caused  by  the  foot  touching  the  ground. 
When  this  stage  is  reached  general  disturbance  becomes  marked,  fever 
sets  in,  rumination  stops,  and  appetite  is  lost. 

These  symptoms  jjoint  to  the  occurrence  of  suppuration.  The  pus, 
confined  within  the  horny  covering  of  the  foot,  causes  very  acute  suffering 
and  sometimes  grave  general  disturbance  ;  later  it  burrows  in  various 
directions,  separating  the  podophyllous  tissue  from  the  horn,  and  ends  by 
breaking  through  "  between  hair  and  hoof "  in  the  region  of  the  coronet. 
In  excejDtional  cases,  comj^lications  such  as  necrosis  of  the  podophyllous 
tissue  extending  to  the  bone,  and  suppuration  of  its  spongy  tissue,  may 
be  observed. 

Diagnosis.  "When  the  farrier  suspects  he  has  pricked  an  animal 
the  immediate  withdrawal  of  the  nail  will  remove  any  doubt,  because 
bleeding  usually  follows.  If  the  condition  is  only  detected  at  a  later 
stage,  the  early  lameness  having  been  misinterpreted,  examination  of 
the  claw  and  taj^ping  the  clenches  of  the  nails  will  cause  the  animal 
to  show  pain  at  a  given  point,  thus  indicating  the  penetration  of  the 
nail.  Removal  of  the  offending  nail  is  painful,  and  is  often  followed  by 
discharge  of  pus  or  blood-stained  fluid,  which  clearly  points  to  the 
character  of  the  injury.  In  obscure  cases  the  shoe  should  not  be 
reapplied. 

When  the  horn  wall  is  separated  from  the  sensitive  structures,  there  is 
marked  general  disturbance,  and  pus  is  discharging  at  the  coronet,  it  is 
practically  imiiossible  to  err  in  diagnosis. 

Prognosis.  In  cases  of  simple  nail  puncture  the  prognosis  is  hopeful, 
provided  that  the  condition  is  at  once  diagnosed.     The  longer  it  remains 


PRICKS    AND    STABS    IN    SHOEING.  37 

unrecognised,  particularly  if  complication  like  necrosis  has  occurred,  the 
graver  becomes  the  outlook. 

Treatment.  In  cases  of  simple  puncture  the  nail  should  immediately 
be  withdrawn  and  the  animal  placed  on  a  perfectly  clean  bed  to  prevent 
the  wound  becoming  soiled  or  infected.  If  lameness  appear  and  become 
aggravated,  the  shoe  should  be  removed  and  antiseptic  poultices  applied. 
In  the  majority  of  cases  the  lameness  will  then  diminish,  and  in  a  few 
days  comj^letely  disappear. 

In  cases  of  discovery  within  the  first  few  days  the  same  treatment  is 
applicable,  and  is  often  sufficient.  If,  on  the  contrary,  pus  is  discharging 
at  the  coronet,  if  lameness  is  intense  and  the  general  symptoms  marked, 
it  may  be  needful  to  operate. 

The  stages  of  operation  comprise :  thorough  thinning  of  the  horn  in  the 
shape  of  an  inverted  V  over  the  afiected  portion  of  the  wall,  removal  of 
the  loose  necrosed  parts,  disinfection  of  the  wound,  and  the  application 
of  a  surgical  dressing  covering  the  entire  claw. 

PICKED-UP    NAILS,   Etc.     r  GATHERED    NAIL.") 

Penetrating  wounds  of  the  plantar  region  are,  as  in  the  horse,  usually 
included  under  the  heading  of  "  Picked-up  Nails."  They  are  only  seen 
in  oxen  or  cows  which  are  not  shod.  Pointed  objects,  like  nails,  harrow 
teeth,  sharp  fragments  of  wood  or  glass,  etc.,  may  produce  injuries  of 
the  character  of  that  now  in  question. 

In  considering  the  position  of  such  wounds  we  may  for  convenience 
divide  the  plantar  region  into  two  zones,  one  extending  from  the  toe  of 
the  claw  to  the  point  of  insertion  of  the  perforans  tendon,  the  other 
comprising  the  region  between  this  insertion  and  the  bulb  of  the  heel. 

Symptoms.  Lameness  occurs  immediately,  and  varies  with  the  in- 
tensity of  the  existing  pain.  If  the  offending  body  has  not  remained 
fixed  in  the  wound,  this  lameness  may  in  a  few  moments  disappear, 
either  for  good  or  merely  for  a  time.  The  recurrence  of  lameness  on 
the  following  day  or  a  couple  of  days  later  marks  the  commencement 
of  inflammatory  changes  in  the  deeper  seated  tissues.  This  lameness 
in  many  instances  is  accompanied  by  a  movement  suggestive  of  string- 
halt,  the  foot  being  kept  on  the  ground  only  for  a  very  short  time,  or 
sometimes  not  being  brought  into  contact  with  the  ground  at  all. 

The  depth  to  which  the  offending  object  has  penetrated,  and  the 
direction  it  has  taken,  may  sometimes  be  discovered  by  a  mere  casual 
examination  of  the  sole.  In  other  cases  only  the  orifice  by  which  it  has 
penetrated  can  be  found.  If  the  injury  has  existed  for  several  days,  the 
discharge  from  the  puncture  will  be  thin  aiid  blackish,  purulent,  or 
blood-stained,  according  to  the  case.  Fever  and  general  systemic  dis- 
turbance suggest  an  injury  of  a  grave  character. 


38  DISEASES   OF   THE    FOOT, 

Diagnosis.  The  diagnosis  is  easy,  inasmuch  as  the  lameness  ahiiost 
directs  examination  to  the  foot. 

Prognosis  is  rarel}^  grave.  The  direction,  the  situation  and  mode  of 
insertion  of  the  flexor  tendon,  which  forms  the  plantar  aponeurosis, 
ensure  this  aponeurosis  being  rarely  injured  by  objects  penetrating  from 
without.  The  points  of  the  offending  bodies  usually  pass  either  forwards 
to  tlie  phalanx  or  backwards  in  the  direction  of  the  plantar  cushion. 

Treatment.  The  first  stage  in  treatment  consists  in  removing  the 
foreign  body  and  thoroughly  thinning  the  neighbouring  horn.  An 
antiseptic  poultice  consisting  of  linseed  meal  saturated  with  B  per  cent, 
carbolic  acid  or  creolin  solution  is  then  applied.  Considerable  and  pro- 
gressive improvement  usually  takes  place  in  a  few  hours.  If  lameness 
persists,  surgical  interference  becomes  necessary ;  in  the  anterior  zone 
it  is  confined  to  removing  any  dead  portions  of  the  velvety  tissue  and  to 
extirpating  the  fragment  of  bone  which  has  undergone  necrosis.  In  the 
posterior  zone  the  sinus  must  be  probed  and  laid  open,  so  that  all  the 
diseased  parts  can  be  treated  as  an  open  wound. 

If,  as  happens  in  exceptional  cases,  the  plantar  aponeurosis  is  found 
to  be  severely  injured,  the  complete  operation  for  picked-up  nail,  as 
practised  in  the  horse,  may  be  performed,  or  the  claw  may  be  ampu- 
tated. In  the  former  operation  the  horn  covering  the  sole  is  first 
thinned  "  to  the  blood." 

The  stages  of  operation  are  as  follows : — 

(1.)  Ablation  of  the  anterior  portion  of  the  plantar  cushion.  Trans- 
verse vertical  incision  at  a  distance  of  1^  inches  in  front  of  the  heel ; 
excision  of  the  anterior  flap. 

(2.)  Transverse  incision  and  ablation  of  the  plantar  aponeurosis  b}^ 
the  same  method. 

(3.)  Curettage  of  the  i^oint  of  implantation  of  the  aponeurosis  into 
the  bone. 

(4.)  Antiseptic  dressing  of  the  claw. 
Finally,  if  the  primary  lesion,  wherever  it  may  have  started,  has 
become  complicated  by  arthritis  of  the  interphalangeal  joint,  it  will 
be  necessary  to  remove  the  claw,  or,  l)etter  still,  to  remove  the  two 
last  phalanges,  the  latter  operation  being  easier  than  the  former,  and 
providing  flaps  of  more  regular  shape  and  better  adapted  for  the 
production  of  a  satisfactory  stump. 

INFLAMMATION    OF    THE    INTERDIGITAL    SPACE. 
(CONDYLOMATA.) 

Condylomata  result  from  chronic  inflammation  of  the  skin  covering 
the  interdigital  ligament.  Any  injury  to  this  region  causing  even 
superficial  damage  may   result    in    chronic    inflammation  of    the    skin 


INFLAMMATION    OF    THE    INTERDIGITAL   SPACE. 


39 


and  hypertrophy  of  the  papinpe,  the  first  stage  in  tlie  production  of 
condylomata. 

Injuries  produced  by  cords  sHpped  into  the  interdigital  space  for 
the  purpose  of  Hfting  the  feet  when  shoeing  working  oxen  are  also 
fruitful  causes. 

Inflammation  of  the  interdigital  space  is  also  a  common  complication 
of  aphthous  eruptions  around  the  claws  and  in  the  space  between  them. 
Continual  contact  with  litter,  dung  and  urine  favour  infection  of  super- 
ficial or  deep  wounds,  and  by  causing  exuberant  granulation  lead  to 
hypertrophy  of  the  papillary  layer  of  the  skin.  When  the  animal 
stands  on  the  foot  the  claws  separate  under  the  pressure  of  the  body 
weight  and  the  condylomata  are  relieved  of  pressure.  When,  however, 
the    limbs   are    rested,    the    claws    mutually    approach,   compress    the 


Fig.  10.  —  Cond^iloiiiata  of  lliu  iutenligitul  space  and  sidebones. 

abnormal  vegetations,  flatten,  excoriate,  and  irritate  them,  thus  favouring 
their  further  development. 

The  symptoms  are  easy  to  detect.  The  animals  appear  in  perfect 
health,  but  have  difficulty  in  walking,  and  show  pain.  They  walk  as 
though  on  sharp,  rough  ground,  and  lameness  is  sometimes  severe. 
Locally,  the  anterior  surface  of  the  claws  and  the  interdigital  space 
are  markedly  congested  and  sensitive,  or  painful  on  pressure.  The 
growths  are  of  varying  size,  isolated  or  confluent,  bleeding,  excoriated, 
or  covered  with  horn,  and  are  visible  between  the  claws  when  the  animal 
stands  on  the  limb.  In  many  cases  they  form  a  perfect  cast  of  the 
vertical  interspace.  When  the  superficial  layers  have  undergone 
conversion  into  a  horn-like  material,  lameness  diminishes  or  disappears. 

Diagnosis  presents  no  difficulty. 

Prognosis  is  only  grave  in  so  far  as  the  condition  interferes  with 
animals  working,  but  it  may  render  working  oxen  entirely  useless. 

Treatment  in  the  early  stages  is  of  a  preventive  character,  and 
consists  in  placing  animals  which  have  been  accidentally  injured  or 
attacked  with  foot-and-mouth  disease  on  a  perfectly  clean  bed. 


40  DISEASES    OF    THE    FOOT. 

Surgical  treatment  is  the  only  reliable  method  in  cases  where  hyper- 
trophy of  the  papillary  layer  is  well  marked,  and  is  extremely  simple. 

The  animal  should  be  fixed  in  the  trevis,  the  foot  to  be  operated  on 
separately  secured,  and  the  growths  completely  removed  with  sharp 
scissors  or  with  a  bistoury  and  forceps.  When  bleeding  has  subsided 
the  wound  is  covered  with  a  mixture  of  equal  parts  of  iodoform,  tannin, 
and  powdered  boric  acid,  and  an  interdigital  dressing  is  applied.  The 
dressing  is  removed  after  five  to  ten  days,  according  to  circumstances. 
If  the  cicatrix  shows  signs  of  exuberant  growth  it  is  dusted  with 
powdered  burnt  alum,  and  the  parts  are  treated  as  an  open  wound. 
When  the  growths  are  covered  with  horn  and  no  longer  painful  it  is 
not  desirable  to  interfere  with  them. 

CANKER. 

Canker — i.e.,  chronic  suppurative  inflammation  of  the  podophyllous  or 
velvety  tissue — is  accompanied  by  hypertrophy  of  the  papilla  and  pro- 
gressive separation  of  the  horn  of  the  sole.  It  is  much  rarer  in  the  ox 
than  in  the  horse,  although  it  occasionally  occurs. 

Prolonged  retention  in  dirty  stables,  where  the  bedding  is  mixed  with 
manure  and  continually  moistened  with  urine,  is  the  principal  cause  of 
the  disease.  Individual  predisposition  and  the  action  of  some  specific 
organism  may  also  have  some  influence. 

Canker  in  oxen,  like  the  same  disease  in  horses,  is  recognised  by 
softening  and  separation  of  the  horn  of  the  sole,  and  by  progressive 
extension  of  the  process  towards  neighbouring  parts.  The  usual  course 
consists  in  invasion  of  the  podoph^^llous  tissue,  separation  of  the  wall  and 
of  the  heels,  and  pathological  hypertrophy  of  the  horn-forming  tissues, 
producing  condylomata. 

The  new  growths  do  not  attain  the  same  dimensions  as  in  the  horse, 
but,  on  the  other  hand,  the  disease  very  frequently  takes  a  progressive 
course,  involving  the  whole  of  the  claw.  A  trifling  accidental  injury  may 
be  followed  by  infection  of  the  subungual  tissues,  and  thus  become  the 
point  of  origin  for  canker. 

Canker  may  attack  only  one  claw  ;  on  the  other  hand,  it  may  extend 
to  both  claws  of  one  foot,  or  to  the  claws  of  more  than  one  foot  in  the 
same  animal. 

Diagnosis.  Diagnosis  is  easy.  The  separation  of  the  horn,  the 
presence  of  a  caseous,  greyish-yellow  and  offensive  discharge  between 
the  separated  parts  and  the  horn-secreting  tissues,  the  appearance  of 
the  exposed  living  tissues,  etc.,  leave  no  room  for  doubt. 

Prognosis.  The  prognosis  is  grave;  for,  as  in  the  horse,  the  disease 
is  obstinate. 


PANARITIUM — FELON — WHITLOW.  41 

Treatment  consists  in  scrupulously  removing  all  separated  horn,  so 
as  fully  to  expose  the  tissues  attacked  by  the  disease.  The  parts  should 
then  be  thoroughly  disinfected  with  a  liquid  antiseptic,  and  a  i^rotective 
pressure  dressing  applied. 

As  a  rule,  cauterisation  with  nitric  acid,  followed  by  applications  of 
tar  or  of  mixtures  of  tannin  and  iodoform,  iodoform  and  powdered  burnt 
alum,  etc.,  effect  healing,  without  such  free  use  of  the  knife  as  has  been 
recommended  in  the  horse  during  the  last  few  years. 


GREASE. 

Grease  in  the  ox  seems  only  to  have  been  described  by  Morot  and 
Cadeac,  and  even  in  these  cases  the  descriptions  appear  rather  to  apply 
to  elephantiasis  or  fibrous  thickening  of  the  skin  than  to  grease  proper. 
Tbe  descriptions  are  not  sufficiently  clear,  and  the  symptoms  described 
differ  too  much  from  the  classical  type  seen  in  the  horse  to  convince  us 
without  further  confirmation  of  the  occurrence  of  the  disease. 


PANARITIUM-FELON-WHITLOW. 

Any  injury  in  the  interdigital  space  or  flexure  of  the  pastern  may, 
under  unfavourable  circumstances,  be  complicated  l)y  death  of  the  skin, 
necrosis  of  the  interdigital  ligament,  of  the  fibro-fatty  cushion  in  the 
flexure  of  the  pastern,  and  of  the  terminal  portions  of  the  tendons. 

These  lesions  are  sometimes  regarded  as  panaritium.  In  reality, 
they  correspond  exactly  to  what,  in  the  horse,  are  known  as  "cracked 
heels"  and  "  quittor."  The  primary  injury  becomes  infected  with 
organisms  which  rapidly  cause  death  of  the  skin  or  the  formation  of  a 
deep-seated  abscess  and  necrosis  of  the  invaded  tissues. 

Causation.  Neglect  of  sanitary  precautions  and  filthy  stables  con- 
stitute favouring  conditions,  the  feet  being  continually  soiled  and  irritated 
by  the  manure  and  urine.  Animals  reared  on  plains,  and  having  broad, 
flat,  widely-separated  claws,  are  more  predisposed  than  animals  from 
mountainous  regions,  in  which  the  interdigital  ligament  is  stronger  and 
the  separation  of  the  claws  less  marked.  Any  injury,  abrasion,  or  cut 
may  serve  as  a  point  of  origin  for  such  complications. 

Panaritium  may  even  occur  as  an  enzootic  with  all  the  characters 
noted  in  isolated  cases.  In  Germany  it  has  received  the  name  of  "con- 
tagious foot  disease."  These  enzootic  outbreaks  of  panaritium  follow 
epizootics  of  foot-and-mouth  disease,  with  lesions  about  the  claws. 
Through  the  superficial  aphthous  lesions  the  parts  become  inoculated 
with  bacteria,  and  the  severity  of  the  resulting  injury  is  in  some 
measure  an  indication  of  the  virulence  of  the  infecting  organism. 


42  DISEASES    OF   THE    FOOT. 

Symptoms.  The  Ih-sl  important  symptom  consists  in  intense  local 
pain,  rapidly  followed  by  marked  lameness.  The  affected  region  soon 
becomes  swollen  ;  the  coronary  band  appears  congested  ;  the  skin  of  the 
interdigital  space  projects  both  in  front  and  behind  ;  the  claws  are 
separated,  and  all  the  lower  portion  of  the  limb  appears  congested 
and  o-dematous.  The  engorgement  usually  extends  as  high  as  the 
fetlock,  and  the  parts  are  hard  and  extremely  sensitive.  The  patient 
is  feverish,  loses  appetite,  and  commences  to  waste.  After  five  to  ten 
days  sloughing  occurs  at  some  point — if  the  ligament  is  affected,  in  the 
interdigital  space ;  if  the  tendons,  or  the  fibro-fatty  cushions,  the  slough 
appears  in  the  flexure  of  the  pastern.  The  dead  tissue  may  separate  and  fall 
away,  or  remain  in  position  macerated  in  pus.  Separation  is  generally  slow, 
requiring  from  twelve  to  fifteen  days,  and,  unless  precautions  are  taken, 
complications  occur.  If  only  the  interdigital  ligament  or  fibro-fatty 
cushion  be  necrotic,  recovery  may  be  hoped  for ;  but,  on  the  other  hand, 
if  the  tendons,  tendon  sheaths,  ligaments,  or  bones  are  affected,  complica- 
tions like  suppurating  synovitis,  suppurating  ostitis,  arthritis,  etc.,  super- 
vene, with  fatal  results.  Death  may  occur  from  purulent  infection,  unless 
the  animal  is  slaughtered  early. 

The  diagnosis  is  easy.  The  intensity  of  the  lameness,  separation  of 
the  claws,  swelling  of  the  pastern  region,  sensitiveness  of  the  swollen 
parts,  and  al)sence  of  lesions  in  the  ungual  region  sufficiently  indicate 
the  nature  of  the  condition. 

The  prognosis  is  grave,  for  complications  may  result,  in  spite  of 
proper  treatment. 

Treatment.  Treatment  consists,  first  of  all,  in  thoroughly  cleansing 
the  affected  limb  and  placing  the  animal  on  a  very  clean  bed.  The  parts 
are  next  subjected  to  antiseptic  baths  containing  carbolic  acid,  creolin, 
sulphate  of  zinc,  or  sulphate  of  copper.  It  is  often  more  convenient,  and 
quite  as  efficacious,  to  apply  antiseptic  poultices  to  the  foot  and  pastern, 
and  to  allow  them  to  remain  for  some  days,  being  moistened  several 
times  daily  with  one  of  the  solutions  indicated.  The  effects  are:  rapid 
diminution  of  the  pain,  delimitation  of  the  necrotic  tissues  is  hastened, 
and  the  abscess  is  more  readily  opened. 

Many  practitioners  recommend  early  intervention  in  the  form  of 
deep  scarification  in  the  interdigital  space  or  pastern  region.  The 
local  bleeding,  and  the  drainage  which  takes  place  through  the  wounds 
so  made,  is  said  to  hasten  recovery  or  to  prevent  complications. 

When  the  abscess  has  opened,  and  the  dead  tissue  separated,  the 
abscess  cavity  or  wound  should  be  regularly  washed  out  with  a  disin- 
fecting solution,  to  prevent  compHcations,  in  case  fragments  of  necrotic 
tissue  have  been  retained.  If,  however,  complications  have  occurred,  no 
hesitation  should  be  felt  in  freely  incising  the  parts,  and,  if  necessary,  in 


FOOT    ROT.  43 

removing  one  or  both  phalanges.  When  both  joints  of  one  foot  are 
affected,  and  arthritis  threatens  to  or  has  set  in,  there  is  no  object  in 
treating  the  animal,  and  early  slaughter  is  to  be  recommended. 

In  cases  where  the  disease  follows  foot-and-mouth  disease,  and 
threatens  to  become  enzootic,  it  can  generally  be  prevented  spreading 
by  keeping  the  foot-and-mouth  subjects  on  very  clean  beds,  and 
frequently  washing  the  feet  with  antiseptic  solutions.  Disinfection  of 
the  sheds  is  also  very  desirable. 

FOOT    ROT. 

Foot  rot  is  a  disease  of  sheep,  and,  like  canker,  is  confined  to  the 
claws. 

Thanks  to  the  progress  of  hygiene,  it  tends  to  become  rarer,  but  is 
still  seen  in  the  enzootic  form  in  some  portions  of  England  and  Scotland, 
in  the  mountains  of  Vivarais,  the  Cevennes,  and  the  Pyrenees. 

It  affects  large  numbers  of  animals  at  once,  animals  belonging  to  one 
flock  or  to  neighbouring  flocks  in  one  locality,  and  when  it  invades  a 
sheep  farm,  all  the  animals  may  successively  be  attacked  at  intervals, 
according  to  the  local  conditions. 

Symptoms.  The  disease  develops  rather  insidiously,  and  the  patients 
always  retain  an  excellent  appetite.  It  begins  with  lameness,  which  is 
at  first  slight,  later  becomes  accentuated,  and  in  the  last  j^eriods  is  very 
intense.  On  examination,  the  coronet  and  lower  part  of  the  limb  as 
high  as  the  fetlock  are  found  to  be  swollen.  Palpation  reveals  exaggerated 
sensibility,  and  on  direct  examination,  a  foetid  discharge  is  discovered  in 
the  interdigital  space.  This  discharge,  which  is  peculiar  to  the  onset  of 
the  disease,  only  continues  for  a  week  or  two,  and  is  succeeded  by  a 
caseous  exudate  which  is  always  offensive,  which  moistens  and  macerates 
the  horn,  the  skin,  the  tissues  in  the  interdigital  space,  and  the  region  of 
the  heels.  From  the  20th  to  the  30th  day  after  onset  the  claw  separates 
al)ove  in  the  interdigital  space.  The  separation  extends  towards  the 
heel,  then  to  the  toe,  exposing  ulceration  of  the  subjacent  podophyllous 
tissue. 

From  this  time  the  patients  experience  very  severe  pain,  and,  as  in 
other  diseases  of  the  feet,  remain  lying  for  long  periods.  Movement 
becomes  extremely  painful,  and  the  animals  frequently  walk  on  tlie  knees. 
The  subungual  lesions  become  aggravated,  separation  of  the  claw 
extends,  necrosis  of  the  podophyllous  tissue  and  of  subjacent  tissue 
becomes  more  extensive,  and  the  interphalangeal  ligaments  and  the 
extensor  or  flexor  tendons  become  involved.  Finally,  the  claws  are  lost, 
and  synovitis  and  arthritis  are  added  to  the  complications  already  existing. 

In  an  infected  locality  the  development  is  always  the  same.      The 


44  DISEASES    OF    THK    FOOT. 

animals  lose  flesh,  become  anaemic,  and,  miless  vigorously  treated,  soon 
die.  The  ordinary  duration  of  the  disease  is  from  five  to  eight  months, 
sometimes  more.  If,  however,  patients  are  isolated  and  well  treated 
they  recover. 

Causation.  The  specific  cause  of  foot  rot  still  remains  to  he  dis- 
covered, although  everj'thing  points  to  the  conclusion  that  it  consists 
in  an  organism  capa])le  of  cultivation  in  manure,  litter,  etc.,  for  foot  rot 
is  transmissible  by  cohabitation,  by  mediate  contagion  through  infected 
pasture,  by  direct  contact  and  by  inoculation. 

The  chief  favouring  influences  are  bad  drainage,  filthy  condition  of 
the  folds,  and  herding  in  marshy  localities. 

Diagnosis.  The  condition  can  scarcely  be  mistaken,  for  the  sheep 
suffers  from  no  other  disease  resembling  it,  excepting,  perhaps,  foot-and- 
mouth  disease. 

Prognosis.  The  prognosis  is  grave,  for  the  disease  usually  assumes 
a  chronic  course,  affects  entire  flocks,  and  the  patients  require  individual 
attention. 

Treatment.  The  primary  essential  to  success  in  treatment  consists 
in  separating  and  isolating  the  diseased  animals  in  a  scrupulously  clean 
place  and  providing  a  very  dry  bed. 

In  the  early  stages  the  disease  may  be  checked  by  astringent  and 
antiseptic  foot  baths.  It  is  then  sufficient  to  construct  a  foot-bath  at  the 
entrance  to  the  fold,  containing  either  milk  of  lime,  4  per  cent,  sulphate 
of  iron,  copper  sulphate,  creolin,  etc.  Through  this  the  sheep  are  passed 
two  or  three  times  a  week.  These  precautions  rarely  suffice  when  the 
feet  are  already  extensively  diseased ;  and  when  the  horn  is  separated  to 
any  considerable  extent,  surgical  treatment  is  indispensable.  All  loose 
portions  of  horn  should  be  removed  and  antiseptic  applications  made  to 
the  parts. 

When  a  large  number  of  sheep  are  affected  the  treatment  is  very 
prolonged,  but  it  is  absolutely  indispensable,  and  the  numerous  dressings 
required  necessarily  complicate  the  treatment.  It  would  be  valuable  to 
experiment  with  small  leggings,  which  would  retain  the  dressings  in 
position,  and,  at  the  same  time,  shelter  the  claws  from  the  action  of  the 
litter,  while  favouring  the  prolonged  action  of  the  antiseptic. 

When  the  lesions  are  not  extensive,  a  daily  dressing  is  sufficient. 

Among  the  materials  most  strongly  recommended  are  antiseptic  and 
astringent  ointments  containing  carbolic  acid,  iodoform,  or  camphor. 
Vaseline  with  5  per  cent,  of  iodine  is  very  serviceable,  and  much  to  be 
preferred  to  applications  like  copper  sulphate,  iron  sulphate,  etc.  Its 
greatest  drawback  is  its  expense. 


CHAPTER    III. 

DISEASES  OF  THE  SYNOVIAL  MEMBRANES  AND 
OF  THE  ARTICULATIONS. 

I.— SYNOVIAL    MEMBRANES    AND    ARTICULATIONS. 
SYNOVITIS. 

Inflammation  of  the  sj'iiovial  membranes,  or  synovitis,  may  affect  the 
synovial  sacs  either  of  the  joints  or  of  the  tendon  sheaths.  It  may  be 
acute  or  chronic  and  occur  either  idiopathically  or  follow  the  infliction  of 
an  injury.  Its  two  chief  forms  are  simple,  or  "closed,"  sj^novitis  and 
suppurative,  or  "  open,"  sj-novitis,  the  essential  distinction  between  which 
is  that  in  the  latter  micro-organisms  are  present,  whilst  in  simple 
sj'novitis  they  are  absent.  In  all  cases  the  disease  is  characterised  by 
distension  of  the  sac  affected. 

Synovitis  produced  by  a  wound  communicating  with  the  outer  air 
may  be  complicated  by  suppuration,  and  if  the  synovial  membrane  of  a 
joint  be  involved  the  primary  synovitis  is  almost  always  followed  by 
traumatic  arthritis. 

The  commonest  forms  of  chronic  simple  synovitis  are  : — 

INFLAMMATION    OF    THE    PATELLAR    SYNOVIAL    CAPSULE. 

Inflammation  of  the  synovial  membrane  of  the  femoro-patellar  joint 
is  most  commonly  seen  in  working  oxen  as  a  consequence  of  strains 
during  draught.  It  is  also  found  in  young  animals  which  have 
injured  the  synovial  capsule  through  falls,  slips,  or  over-extension  of 
the  limb. 

Symptoms.  Development  is  slow  and  progressive,  and  injury  may 
not  l)e  discovered  until  the.  lameness  which  follows  has  become  fairly 
marked.  This  lesion  is  characterised  by  swelling  in  the  region  of  the 
stifle.  On  palpation,  fluctuation  may  readily  be  noted  both  on  the  outer 
and  inner  surfaces  of  the  joint.  The  exudate  is  sometimes  so  abundant 
and  distension  so  great  that  the  straight  ligaments,  the  neighbouring 
Ijony  prominences,  and  the  ends  of  the  tendons  are  buried  in  the  liquid 
swelling. 

Lameness,  which  is  at  first  marked,  often  diminishes  with  exercise. 
The  length  of  the  step  is  lessened. 


46        DISEASES   OF   THE   SYNOVIAL   MEMBRANES   AND    ARTICULATIONS. 

Diagnosis.  The  diagnosis  presents  no  difficulty,  but  the  lesions 
must  be  distinguished  from  those  due  to  tuberculosis  in  this  region, 
rheumatic  arthritis,  and  the  specific  arthritis  seen  in  milch  cows. 

The  prognosis  is  grave,  for  the  disease  renders  animals  useless 
for  work. 

Treatment.  Rest,  cold  moist  applications,  and  massage  constitute 
the  best  treatment  in  the  early  stages.  Should  swelling  persist,  one 
may  afterwards  apply  a  smart  blister  or  even  tap  the  joint  aseptically, 
drawing  off  the  fluid  and  then  applying  the  actual  cautery.  Irritant 
injections  must  be  avoided. 

DISTENSION    OF    THE   SYNOVIAL   CAPSULE   OF   THE    HOCK  JOINT. 

Bog  Sjxirin   in   the   Or. 

Bog  spavin  is  frequent  in  working  oxen  and  in  oxen  from  three  to 
five  years  old.  It  is  due  lo  strain  in  draught  or  to  strain  produced  in 
rearing  up  at  the  moment  of  covering.  Old  bulls,  heavy  of  body,  and 
stiff  in  their  limbs  are  predisposed  to  it. 

Symptoms.  The  symptoms  usually  develop  gradually  and  without 
lameness,  but  sometimes  declare  themselves  more  rapidly  with  lameness, 
accompanied  by  marked  sensitiveness  on  palpation.  At  first  the  hock 
show^s  a  generalised  doughy  swelling,  soon  followed  by  dilatation  of  the 
articular  synovial  sac.  Somewhat  later  four  different  swellings  appear— 
two  in  front,  separated  by  the  tendons  of  the  common  extensor  and 
flexor  metatarsi,  and  two  at  the  back,  extending  inside  and  outside  to  the 
flexure  of  the  hock. 

Diagnosis.  The  only  precaution  required  in  diagnosis  is  to  avoid 
confusion  with  articular  rheumatism.    "** 

Prognosis.  The  prognosis  is  rather  grave  in  the  case  of  working 
oxen,  and  even  of  bulls  ;  often  slaughter  is  preferable  to  treatment. 

Treatment  dift'ers  in  no  respect  from  that  of  distension  of  the  stifle- 
joint.  In  young  bulls  aseptic  puncture  and  drainage  of  the  joint, 
followed  l)y  the  application  of  the  actual  cautery,  probably  give  the 
best  results. 

DISTENSION    OF    TENDON    SHEATHS    IN    THE    HOCK    REGION. 

Like  the  preceding,  this  condition  is  rarely  seen  except  in  bulls  and 
working  oxen.  It  is  characterised  by  dilatation  of  the  ui)per  portion  of 
the  tarsal  sheath,  one  swelling  appearing  on  the  outer  side,  the  other  on 
the  inner. 

The  differential  diagnosis  is  based  on  the  position  of  these  synovial 
sacs,  which  are  quite  close  to  the  insertion  of  the  tendo-Achillis,  and  on 
the  absence  of  any  swelling  in  front  of  the  joint. 


DISTENSION    OF   THE   SYNOVIAL   CAPSULE    OF   THE    KNEE   JOINT. 


47 


Treatment  is  identical  with  that  indicated  in  the  last  condition. 

Massage  and  cold  water  applications  should  be  employed  at  first,  to 
be  fohowed  by  aseptic  puncture  and  withdrawal  of  fluid,  supplemented  if 
necessary  by  firing  in  points. 

DISTENSION    OF    THE   SYNOVIAL    CAPSULE    OF    THE    KNEE  JOINT. 

This  is  one  of  the  rarest  conditions  now  under  consideration,  because 
the  synovial  membranes   of   the    knee   joint   are   everywhere    strongly 


Fig.  17. — Front  view  of  the  ox's 
hock,  showing  the  relations  of 
the  tendons  and  synovial  sacs. 


Fig.  18. — Side  view  of  the  ox's  hock.  The  syno- 
vial sac  of  the  true  hock  joint  has  been  injected 
to  show  the  relations  of  the  sacs. 


supported  by  very  powerful  ligaments.  The  synovial  capsules  of  the 
carpo-metacarpal  and  inter-carpal  joints  are  incapable  of  forming  sacs 
of  any  size.  On  the  other  hand,  the  radio-carpal  may  become  moderately 
prominent  in  front,  especially  towards  the  outside  above  the  superior 
carpal  ligament.  When  weight  is  placed  on  the  limb,  the  excess  of 
synovia  is  expelled  from  the  joint  cavity  towards  this  little  sac,  which 


48        DISEASES   OF   THE   SYNOVIAL    MEMBRANES   AND   ARTICQLATlONS, 

then  becomes  greatly  distended.     If,  on  the  other  hand,  the  knee  is  bent, 
the  sac  shrinks  or  disappears. 

Treatment.  Treatment  is  restricted  to  the  appUcation  of  a  Ijhster  or 
to  firing  in  points. 

DISTENSION    OF    THE    SYNOVIAL    CAPSULE    OF    THE 
FETLOCK    JOINT. 

The  synovial  capsule  of  the  fetlock  joint  in  the  ox  is  strongly  sup- 
ported in  front  and  at  the  sides,  but  may  protrude  under  the  anterior 
ligament,  producing  a  swelling  behind  the  metacarpus  under,  the  five 
branches  of  division  of  the  suspensory  ligament  and  slightly  below  the 
sesamoid  bones.  These  distensions,  like  bursal  swellings,  are  commoner 
in  hind  limbs  and  in  old  working  oxen.  Their  development  is  always 
followed  in  time  by  a  certain  degree  of  knuckling  over.  At  first  the 
metacarpus  and  phalanges  come  to  form  a  straight  line,  but  later  the 
fetlock  joint  itself  is  thrust  forward. 

The  diagnosis  necessitates  careful  manual  examination  of  the  region 
of  the  fetlock  joint. 

The  prognosis  is  somewhat  grave,  for  the  disease  sooner  or  later 
necessitates  the  destruction  of  certain  animals. 

Treatment  is  practically  identical  with  that  used  in  all  such  con- 
ditions :  friction  with  camphorated  alcohol,  cold  affusions  and  massage 
in  the  earlier  stages,  followed  if  needful  by  blisters  or  firing  in  points. 

DISTENSION    OF    TENDON    SHEATHS. 

Distension  of  the  synovial  capsule  which  surrounds  the  superior 
suspensory  ligament,  like  distension  of  the  articular  capsule  of  the 
fetlock,  occurs  in  working  animals,  and  most  commonly  affects  the  front 
limbs.  It  is  indicated  by  two  swellings,  one  situated  on  either  side  of 
and  behind  the  branches  of  division  of  the  suspensory  ligament  and  in 
front  of  the  flexor  tendons.  These  two  swellings  extend  higher  than  the 
articular  swellings,  which,  however,  they  sometimes  accompany.  The 
surface  of  the  fetlock  is  then  swollen,  doughy  on  pressure,  and  some- 
what painful. 

These  enlargements  may  produce  more  or  less  marked  lameness  and 
cause  knuckling. 

The  diagnosis  is  clear  from  local  examination. 

The  prognosis  is  unfavourable,  as  the  animals  after  a  time  become 
useless  for  work. 

Treatment.  The  beginning  of  the  disease  may  often  be  cured  by 
balhs  of  running  water,  combined  with  massage.  At  a  later  stage,  local 
stimulants,    blisters,    or    firing    are    necessary.     The    best    treatment 


TEAUMATIC   SYNOVITIS — "OPEN   SYNOVITIS."  49 

probably  consists  in  puncturing  the  parts  with  antiseptic  precautions, 
washing  out  the  synovial  cavity  with  an  antiseptic,  and  immediately 
afterwards  lightly  firing  the  surface  of  the  region  in  points. 

DISTENSION    OF    TENDON    SHEATHS    IN    THE    REGION 
OF    THE    KNEE. 

Any  of  the  numerous  tendon  sheaths  which  facilitate  the  gliding  of 
tendons  in  the  neighbourhood  of  the  knee  may  become  ■  inflamed 
and  give  rise  to  a  chronic  synovial  swelling.  The  commonest  of 
such  swellings  is  due  to  distension  of  the  sheath  of  the  extensor 
metacarpi'  magnus,  which  appears  as  a  vertical  line  in  front  of  the 
knee,  extending  from  the  lower  third  of  the  forearm  and  slightly  to 
the  outer  side  of  the  central  line.  This  synovial  enlargement  arises  in 
oxen  working  on  broken  roads,  in  clay  or  marshy  soils,  where  the 
animals  are  liable  to  stick  fast,  and  are  often  obliged  to  struggle 
vigorously  in  order  to  extricate  themselves. 

The  diagnosis  is  based  on  the  position  and  direction  of  the  dilated 
synovial  sheath. 

Treatment  is  identical  with  that  of  other  cases  of  chronic  synovitis. 

DISTENSION    OF    THE    BURSAL    SHEATH    OF    THE    FLEXOR 
TENDONS. 

This  condition  is  rare.  It  is  announced,  as  in  the  horse,  by  a 
dilatation  of  semi-conical  form,  the  apex  of  which  is  situated  opposite  the 
lower  margin  of  the  carpal  sheath,  the  base  extending  as  high  as  the 
infero-posterior  third  of  the  radius. 

The  dilatation  is  more  marked  on  the  inner  than  on  the  outer  side 
of  the  limb. 

Distension  of  the  synovial  sheath  of  the  common  extensor  of  the 
digits  in  the  fore  limb  and  of  the  extensor  of  the  external  digit  is  still 
rarer  than  the  preceding  conditions. 

TRAUMATIC    SYNOVITIS-"  OPEN    SYNOVITIS." 

^Yhen  an  injury  in  the  neighbourhood  of  a  joint  penetrates  deeply,  it 
may  implicate  either  the  synovial  sheath  of  a  tendon  or  the  synovial 
membrane  of  a  joint.  If  the  body  inflicting  the  wound  is  aseptic,  a 
condition  which  in  accidental  wounds  is  rare,  the  wound  may  have  no 
grave  consequences.  Usually,  however,  the  body  producing  the  injury 
is  infected,  and  the  infection  rapidly  extends  throughout  the  tendon 
sheath  or  synovial  sac.  In  the  first  case,  traumatic  suppurating  synovitis 
of  a  tendon  sheath  is  the  result ;  in  the  second,  a  suppurating  articular 
synovitis  arises,  which  soon  becomes  complicated  with  injury  of  the 
articular  cartilages,  ligaments,  etc.  (traumatic  arthritis). 

D.C.  E 


50        DISEASES   OF   THE    SYNOVIAL    MEMBRANES    AND   ARTICULATIONS. 

The  primary  lesion  maj'  oiil}^  affect  the  periarticular  region,  not 
directly  extending  to  the  synovial  membranes,  and  only  after  an  interval 
of  some  days  may  symptoms  of  suppurating  synovitis  or  suppurating 
arthritis  appear,  in  consequence  of  progressive  invasion  of  the  parts  by 
specially  virulent  microl)es. 

TRAUMATIC    TENDINOUS    SYNOVITIS. 

Suppurative  inflammation  of  the  synovial  bursffi  of  tendons  in  conse- 
quence of  wounds  most  commonly  affects  the  sesamoid  sheaths  of  the 
front  or  hind  limbs  ;  more  rarely,  the  tendon  sheaths  of  the  hock  or 
knee  ;  and,  exceptionally,  the  small  synovial  sheaths  of  the  extensors  of 
the  metacarpus  and  phalanges,  etc. 

Such  inflammation  follows  injuries  with  forks,  harrow  teeth,  or  any 
sharp  foreign  body.  It  is  characterised  by  the  existence  of  a  fistula  or 
wound,  indicating  the  course  taken  by  the  body  inflicting  the  injury, 
from  which  at  first  normal  synovia  escapes.  Later,  however,  the 
discharge  becomes  turbid,  and  after  the  second  day  gives  place  to  a 
clotted,  serous,  or  purulent  fluid. 

A  diffuse,  oedematous,  warm,  painful  swelling  very  rapidly  develops 
around  the  injury.  The  animal  is  more  or  less  feverish  and  lame.  The 
swelling  soon  extends  throughout  the  entire  length  of  the  infected 
synovial  sheath.  The  patient  loses  appetite,  and  unless  treatment  is 
promptly  undertaken,  complications  supervene  which  often  necessitate 
slaughter.     The  prognosis  is  always  grave. 

Treatment.  Continuous  irrigation  has  long  been  recommended.  It 
is  worthy  of  trial,  but  in  the  majority  of  cases  occurring  in  current 
practice  it  cannot  be  carried  out. 

Moussu  prefers  a  form  of  treatment  which  he  claims  has  always 
succeeded  in  horses  and  oxen — viz.,  irrigation  of  the  parts,  followed  by 
injection  of  sublimate  glycerine  solution. 

He  first  washes  out  the  infected  synovial  cavity  with  boiled  water 
cooled  to  100°  Fahr.  A  counter-opening  may  become  necessary,  and 
the  washing  should  be  continued  until  the  escaping  water  appears 
perfectly  clear.  Immediately  after  each  such  irrigation  he  injects  from 
7  to  14  drams  of  glycerine  containing  1  part  in  1,000  of  corrosive 
sublimate.     He  repeats  this  treatment  daily. 

By  reason  of  its  affinity  for  water  and  for  the  liquids  in  the  tissues  or 
suppurating  cavities  into  which  it  is  injected,  the  glycerine  penetrates 
in  all  directions,  reaching  the  finest  ramifications  of  the  synovial  sacs,  a 
fact  which  explains  its  superiority  over  aqueous  antiseptic  solutions. 

Suppuration  is  rapidly  checked  and  repair  becomes  regular.  The 
pain  and  lameness  progressively  diminish,  and  recovery  may  be  complete. 


TRxVUMATIC   ARTICULAR    SYNOVITIS — TRAUMATIC   ARTHRITIS. 


It  is  advisable  to  assist  this  internal  antiseptic  treatment  by  external 
stimulants  and  by  the  use  of  a  blister.  Solutions  of  greater  strength 
than  1  part  of  sublimate  to  500  of  glycerine  are  only  required  during  the 
first  few  days  of  treatment  and  until  suppuration  diminishes.  Later, 
they  prove  irritant,  and  interfere  with  healing. 

TRAUMATIC    ARTICULAR    SYNOVITIS-TRAUMATIC    ARTHRITIS— 
"OPEN    ARTHRITIS." 

It   has   been   described    above   how    primary   inflammation    of   the 
articular  synovial  membrane 
produced   by  a  wound   may 
rapidly    develop     into     sup- 
purating arthritis. 

Symptoms.  The  pain  is 
very  marked  at  the  moment 
when  the  accident  occurs, 
but  this  pain,  due  to  the 
mechanical  injury  inflicted, 
diminishes  or  completely  dis- 
appears after  some  hours. 
Soon,  however,  synovial  dis- 
charge sets  in,  announcing 
the  onset  of  traumatic  syno- 
vitis. At  first  limpid,  it 
soon  becomes  turbid,  then 
curdled,  and  finally  grumous, 
purulent  and  greyish  in 
colour. 

Pain  then  returns,  rapidly 
becomes  intense,  continuous 
and  lancinating.  It  produces 
lameness,  sometimes  so  severe 
that  no  weight  whatever  can 
be  borne  on  the  limb.  A 
difl'use,  oedematous,  warm  and 
extremely  sensitive  swelling 
then  rapidly  develops  around 
the  whole  of  the  injured  joint. 

General  disturbance,  with  fever  and  loss  of  appetite,  appears,  indicating 
a  ver}^  alarming  condition. 

It  is  sometimes  a  little  difficult  to  differentiate  between  this  condition 
and  that  due  to  injury  of  a  tendon  sheath,  Init  as  a  rule  diagnosis  is  easy. 

Prognosis  is  very  grave.     Life  is  threatened,  and  wasting  occurs  very 

E  2 


/ 


V 


^i 


Fig.  19. — Suppurative  arthritis  of  the  fetlock. 


)2        DISEASES   OF   THE   SYNOVIAL   MEMBRANES   AND   ARTICULATIONS. 


rapidly.  Infection  of  the  synovial  membrane  is  soon  followed  by 
necrosis  and  erosion  of  the  articular  cartilages,  as  well  as  by  softening 
and  inflammatory  change  in  the  ligaments,  etc. 

Treatment.  Should  the  patient  be  in  reasonably  good  condition,  but 
otherwise  of  no  particular  value,  it  should  at  once  be  slaughtered.  If,  on 
the  other  hand,  it  possess  a  special  value,  and  the  owner  wish  to  preserve 

its    life,    the    same    antiseptic 

'  '       ^'-*^  treatment  should   be   adopted 

£]      ;;  \,      ,  as   was    indicated    in    dealing 

'  "y""'^'    '  with  suppurating  synovitis  of 

tendon  sheaths.  The  loss  of 
the  articular  cartilage  of  the 
joint  is  followed  by  free  granu- 
lation and  union  of  the  apposed 
surfaces  of  bone  resulting  in 
anchylosis  of  the  joint  and 
qualified  recovery.  Such  re- 
sults, however,  are  only  likely 
to  follow  in  relatively  light 
animals  which  are  capable  of 
standing  for  considerable 
periods. 

II.— STEAINS    OF    JOINTS. 

When,  in  consequence  of 
muscular  contraction  or  ex- 
ternal violence,  the  bony  sur- 
faces constituting  a  joint  are 
displaced  so  as  to  stretch, 
lacerate,  or  partially  tear  the 
ligaments,  synovial  capsule  or 
tendons  supporting  the  joint, 
so-called  sprain,  or  strain,  or 
wrench  results.  The  articular  surfaces  are  not  sufficiently  displaced  to 
cause  luxation,  but  a  series  of  periarticular  injuries  result,  and  are 
followed  by  the  symi^toms  which  we  recognise  as  those  of  strain.  Joints 
in  Avhich  movement  is  restricted  within  narrow  limits,  such  as  the  hock 
or  fetlock,  are  most  liable  to  such  injuries,  which  also  occur  in  very  freely 
movable  articulations  like  the  shoulder  and  stifle. 


Fig.  20. — Suppurative  art! iritis  following 
traumatic  osteo-periostitis. 


STRAIN    OF    THE    SHOULDER. 

This  accident  is  produced  by  the  animal  falling  on  its  side,  by  slipping 
at  the  moment  of  landing,  the  limb  being  extended  and  in  contact  with 


STRAIN    OF    THE    KNEE,  o3 

the  ground,  by  the  foot  shpping  at  the  moment  when  it  is  leaving  the 
ground  and  the  Hmb  is  at  its  extreme  Kmit  of  backward  extension,  by 
side  shps,  etc.  The  periarticular  lesions  will  then  be  found  on  the 
front,  back,  or  internal  surface  of  the  articulation,  depending  on  the 
manner  in  which  the  accident  has  occurred.  According  to  some  authors, 
violent  muscular  efforts,  as  well  as  work  in  soft  clay  soil,  bogs  and  rice 
swamps,  are  also  capable  of  causing  strain  of  the  shoulder. 

Symptoms.  At  first  moving  appears  difficult,  the  patient  lies  down 
a  great  deal,  then  lameness  becomes  characteristic.  Movement  of  the 
scapulo-humeral  joint  being  painful,  the  patient  endeavours  as  far  as 
l^ossible  to  avoid  it ;  the  limb  is  advanced  stiffly  in  an  abducted  position 
and  with  a  mowing  movement.  This  semi-circular  movement  avoids 
the  necessity  of  flexing  the  scapulo-humeral  angle,  but  diminishes  the 
length  of  the  stride. 

Locall}^  the  region  of  the  scapulo-humeral  angle  is  swollen,  doughy, 
and  extremely  sensitive  on  manual  examination.  If  the  practitioner 
endeavours  to  flex  it  by  lifting  the  limb  the  animal  flinches. 

Diagnosis.  The  diagnosis  is  not  very  difficult,  although  the  peculiar 
mowing  movement  is  also  seen  in  other  cases,  such  as  cracked  heels  and 
mallenders. 

Prognosis.  The  prognosis  is  favourable,  for,  provided  there  has  been 
only  a  moderate  strain  of  the  tendons  or  isolated  injury  to  the  muscles, 
recovery  is   almost  certain. 

Treatment.  Treatment  consists  in  resting  the  animal  and  in 
assisting  repair. 

The  parts  can  be  immobilised  by  the  application  of  a  vesicant  or 
mild  blister.  A  week  or  ten  days  later  dry  friction,  muscular  and  peri- 
articular massage  are  indicated,  and  gentle  exercise  should  be  commenced. 
The  same  treatment  may  be  employed  in  strain  of  the  ell)ow  joint  and 
in  strains  of  muscles  or  tendons  in  the  neighbourhood  of  joints.  Such 
lesions  are,  however,  very  rare  in  the  ox. 

STRAIN    OF    THE    KNEE. 

Strain  of  the  knee  is  commoner  in  the  ox  than  in  the  horse,  because  of 
the  special  conformation  of  the  knee  in  the  ox  and  the  mode  of  working 
under  a  yoke.  This  mode  of  working  gives  less  individual  liberty  to  the 
fore  quarters,  and  sometimes  interferes  with  the  animal's  efforts  when 
moving  a  load.  Strains  of  ligaments  and  periarticular  injuries  occur  as 
a  general  rule  on  the  inner  side  of  the  limb. 

The  symptoms  consist  in  lameness,  exaggerated  sensibility  on  pressure, 
pain  on  forced  flexion  of  the  knee,  and  swelling  of  the  entire  periarticular 
region. 

The  prognosis  is  somewhat  serious  in  working  oxen. 


54        DISEASES   OF   THE   SYNOVIAL   MEMBRANES    AND   ARTICULATIONS. 

Treatment,  when  applicable,  should  consist  of  stimulant  dressings, 
massage,  and  douches. 

STRAIN    OF    THE    FETLOCK. 

This  is  one  of  the  commonest  accidents  of  draught  oxen. 

Causation,  Working  on  rough,  irregular,  rocky  ground,  or  on  roads 
with  deep  ruts,  is  the  commonest  cause  of  this  condition.  When  the 
animal  moves  on  irregular  surfaces  the  two  claws  do  not  hear  an  equal 
share  of  weight ;  sometimes  the  whole  weight  is  for  a  moment  thrown 
on  one  claw. 

The  phalanges,  therefore,  are  displaced  inwards  or  outwards,  or  are 
twisted  around  their  vertical  axis,  causing  the  fetlock  joint  and  its  sup- 
porting ligaments  to  he  more  or  less  severely  strained.  The  internal  or 
external  ligaments  of  the  joint  or  the  suspensory  ligament  or  flexor 
tendons  may  even  he  lacerated. 

The  fetlock  may  also  he  strained  by  the  animal  making  violent  efforts 
to  free  the  claws  or  pastern  which  have  become  fixed  in  a  hole  in  the 
ground,  in  bogging,  in  hobbling,  or  in  leaping  a  fence. 

Symptoms.  Lameness  is  noticeable  from  the  beginning,  but  is 
unaccompanied  by  any  visible  lesion.  On  examination  of  the  limb,  the 
entire  region  from  the  fetlock  downwards  is  found  to  be  sensitive  to 
pressure,  and  painful  when  forcibly  extended  or  flexed  from  side  to 
side.  This  sensitiveness  is  particularly  marked  when  the  phalanges  are 
rotated  on  the  shank.  A  few  days  later  the  entire  fetlock  becomes  the 
seat  of  diffused  swelling. 

Diagnosis  is  facilitated  by  the  fact  that  the  fetlock  has  an  entirely 
different  appearance  from  that  seen  when  tendon  sheaths  or  the  synovial 
capsules  of  joints  are  distended. 

Prognosis.  The  prognosis  varies  considerably,  according  to  the  extent 
to  which  deep-seated  structures  are  involved,  and  the  gravity  of  the 
lesions  is  usually  proportioned  to  the  intensity  of  the  symptoms. 

Treatment.  Frequent  cold  applications,  cold  foot  baths  for  an  hour 
or  two  night  and  morning,  and  even  cold  poultices  are  useful.  When 
the  pain  has  somewhat  diminished,  which  usually  occurs  in  from  three 
to  four  days,  vesicants  may  be  employed,  and,  at  a  later  stage,  massage. 
Failing  improvement  by  these  methods,  the  injured  region  may  l)e  fired 
in  points. 

Strain  of  the  hind  fetlock  occurs  under  precisely  similar  conditions  to 
those  al)ove  descrilied  in  the  case  of  front  limbs. 

STRAIN    OF    THE    STIFLE    JOINT. 

Strain  of  the  stifle  joint  results  from  over-extension  of  ligaments 
without   displacement   of    the    patella,    and    also    (and    probably   more 


STRAIN   OF   THE   HOCK   JOINT.  55 

frequently)  from  injuries  to  the  aponeurosis  and  tendons  of  insertion  of 
the  abductor  muscles  of  the  femur  and  tibia. 

Causation.  Strain  of  the  stifle  may  follow  violent  collisions,  such  as 
occur  in  entering  or  leaving  the  stable,  from  falls  on  rough  ground,  from 
direct  blows,  from  slips,  etc.,  or  even  from  the  sudden  and  violent 
contraction  of  the  muscles  of  the  antero-external  surface  of  the  quarter. 

Symptoms.  Lameness  follows  immediately  or  soon  after  the  accident, 
and  is  of  a  peculiar  character  ;  to  avoid  using  the  injured  joint,  the 
animal  advances  the  hind  limb  with  a  mowing  movement. 

The  injured  region  exhibits  diffuse  inflammatory  swelling,  which 
impedes  palpation,  and  makes  it  difiicult  to  determine  the  exact  nature 
of  the  local  lesion.     The  thigh  at  the  stifle  is  painful. 

Diagnosis  and  prognosis.  Diagnosis  presents  no  considerable  diffi- 
culty. The  prognosis  must  be  based  on  the  intensity  of  the  symptoms, 
and  becomes  grave  if  the  tendons  or  aponeurotic  insertions  be  injured, 
or  extensive  damage  have  been  done  to  ligaments. 

Treatment.  At  first,  continued  cold  applications,  douches,  and 
massage  are  most  useful ;  blisters  are  more  effective  in  the  grave  cases, 
and  comprise  not  only  the  ordinary  blisters,  but  the  powerful  mixed 
blister  containing  tartar  emetic,  powdered  hellebore,  bichromate  of 
potash,  etc.  If  for  any  special  reason  it  is  of  importance  to  preserve 
the  animal's  life,  the  parts  may  be  fired ;  but  for  economic  reasons  it 
is  usually  better  to  fatten  it  for  the  butcher. 


STRAIN    OF    THE    HOCK    JOINT. 

Causation.  Strain  of  the  hock  joint  is  commonest  in  j'oung  oxen 
which  are  being  trained  to  work.  Their  hind  quarters  are  necessarily 
more  or  less  free,  and  the  animals  are  apt  to  make  side  movements  to 
avoid  the  goad,  thus  exposing  the  hock  to  irregular  strain. 

The  internal  ligaments  are  more  frequently  strained  than  the  external, 
a  fact  due  to  the  conformation  of  the  hocks. 

Symptoms.  Strain  is  accompanied  by  lameness,  most  marked  when 
the  animals  endeavour  to  turn,  by  exaggerated  sensibility  of  the  entire 
hock  region,  and,  in  grave  cases,  by  subcutaneous  oedema. 

Diagnosis  and  prognosis.  Diagnosis  is  simple.  The  prognosis  is 
sometimes  grave,  because  a  spavin  or  a  permanent  chronic  enlargement 
of  the  capsule  of  the  true  hock  joint  may  form. 

Treatment.  It  is  often  desirable  at  once  to  apply  an  extensive 
blister  over  the  whole  hock  and  to  supplement  this  at  a  later  stage  by 
cold  applications,  or  by  continuous  cold  irrigation  for  half  an  hour  or 
more  both  night  and  morning. 

In  exceptional  cases  the  use  of  the  actual  cautery  becomes  necessary. 


5G        DISEASES    OF   THE    SYNOVIAL   MEMBRANES   AND    ARTICULATIONS. 

III.— LUXATION   OF   JOINTS. 

Luxation  consists  of  permanent  displacement  of  the  bony  surfaces 
forming  a  joint,  and  may  follo^Y  violent  mechanical  injury  or  any 
other  cause. 

Luxations  have  been  divided  into  congenital,  i.e.,  such  as  exist  from 
the  time  of  birth  ;  spontaneous,  i.e.,  those  which  result  from  some  defect 
of  conformation  or  constitution ;  and  acquired  or  accidental,  which  occur 
as  results  of  falls,  wounds,  accidents,  etc. 

From  the  point  of  view  of  their  duration,  luxations  are  termed 
temporary  when  they  do  not  necessitate  reduction,  progressive  when 
the  tendency  is  towards  greater  and  greater  displacement  of  the  surfaces, 
or  permanent  when  reduction  is  impossible. 

Those  commonest  in  bovines  are  luxations  of  the  femur,  luxation  of 

the  patella,  femoro-tibial  luxation,  and  luxation  of  the  scapulo-humeral 

joint. 

LUXATION    OF    THE    FEMUR. 

Luxation  of  the  head  of  the  femur  with  displacement  beyond  the 
cotyloid  cavity  is  very  frequently  congenital.  The  condition  also  occurs 
with  some  frequency  in  adults  or  aged  animals  in  consequence  of 
relaxation  of  the  articular  ligaments  and  the  absence  of  the  subpubic 
ligament  (pubio-femoral  ligament). 

Causation.  Luxation  may  be  congenital,  the  head  of  the  femur 
being  displaced  backwards  and  carried  above  the  cotyloid  cavity.  This 
form  is  of  no  jjractical  interest,  because  the  animals  are  not  usually 
reared.  More  frequently  in  young  or  adult  animals  it  assumes  the 
spontaneous  progressive  form,  in  consequence  of  degenerative  changes  in 
and  relaxation  of  the  coxo-femoral  interosseous  ligament.  The  head  of 
the  femur  presses  on  the  upper  margin  of  the  cotyloid  cavity,  which  it 
injures,  and  eventually  becomes  lodged  in  the  neighbourhood  of  the  neck 
of  the  ilium,  in  the  great  sciatic  notch. 

This  luxation  is  also  found  as  a  purely  accidental  occurrence  in 
animals  which  have  suffered  from  falls  and  from  slipping  of  the  hind 
limbs  backwards  or  sidewards,  as  occasionally  follows  awkward  leaping 
movements.  The  slipping  outwards  of  the  limbs,  which  causes  this  form 
of  luxation,  is  comparatively  easy,  because  of  the  absence  of  the  pubio- 
femoral  ligament.  The  accident  may  also  be  followed  merely  by 
subluxation,  that  is  to  say,  tearing  of  the  inner  portion  of  the  capsular 
ligament  and  rupture  of  some  portion  of  the  adductor  muscles  of  the 
thigh  without  rupture  of  the  interosseous  fibres,  the  head  of  the  femur 
not  quitting  the  cotyloid  cavity.  This  accident  occurs  in  stables  with 
smooth,  slippery  floors,  and  in  railway  trucks.  It  may  affect  one  side 
or  both.     The  latter  condition  is  exceptional. 


LUXATION   OF   THE   FEMUR.  57 

Finally,  luxation  may  be  either  complete  (in  which  case  the  capsular 
and  interosseous  ligaments  are  both  ruptured)  or  incomplete.  In  the 
former  case,  the  head  of  the  femur  becomes  displaced  upwards  and 
forwards  towards  the  great  sciatic  notch,  more  rarely  backwards  in  the 
direction  of  the  ischium,  and  in  exceptional  cases  downwards  and 
inwards  below  the  pubis  into  the  foramen  ovale. 

Symptoms.  The  symptoms  vary,  depending  on  whether  the  luxation 
is  of  the  spontaneous,  progressive  order  or,  on  the  contrary,  is  accidental. 
In  progressive  luxation,  the  animals  are  able  to  rise  and  walk  with 
difficulty.  The  affected  limb  swings  when  the  animal  is  advancing,  not 
as  though  it  were  paralysed,  but  simply  as  though  displaced  at  its  upper 


Fig.  21. — Accidental  luxation  of  the  hip  joint. 

part.  Pain  is  exhibited  when  weight  is  placed  on  the  limb,  and  there  is 
difficulty  in  movement.  The  limb  appears  shorter  than  its  neighbour 
when  the  animal  stands  on  it,  and  the  prominence  representing  the 
trochanter  is  more  marked.  When  a  false  joint  has  formed,  the  limb  is 
rigid,  is  moved  stiffly  and  abducted,  and  the  stride  is  shortened. 

In  accidental  luxations,  either  of  one  or  both  limbs,  the  attitude 
assumed  by  the  animal  is  often  characteristic.  One  of  the  limbs  is  ex- 
tended at  right  angles  to  the  longitudinal  axis  of  the  body,  and  some- 
times both  limbs  assume  this  position,  an  attitude  which  would  be 
absolutely  impossible  under  normal  conditions.  The  animal  cannot 
rise.  It  lifts  the  front  part  of  the  body  by  rising  on  its  knees,  but  the 
hind  quarters  do  not  follow.  The  ruptured  adductor  muscles  are  unable 
to  bring  and  hold  the  limb  parallel  to  the  longitudinal  axis  of  the  body ; 
the  abductors  act  unopposed,  and  at  the  moment  when  the  animal  makes 


58        DISEASES    OF    THE    SYNOVIAL    MEMBRANES    AND    ARTICULATIONS. 

its  greatest  ell'ort  to  rise  the  limb  (or  liml)s)  is  carried  outwards  and  the 
body  comes  to  the  gromid  on  the  udder  or  groin. 

Inspection  discovers  a  depression  where  the  great  trochanter  should 
be.  On  appl^'ing  the  open  hand  over  the  hip  joint,  whilst  an  assistant 
who  grasps  the  pastern  moves  the  limb  in  different  directions,  one  can 
feel  and  hear,  in  spite  of  the  mass  of  muscle  covering  the  part,  a  modified 
crepitation  due  to  sero-sanguinolent  effusion  in  and  around  the  joint. 
This  crepitation  can  also  be  detected  by  pushing  the  hand  as  high  up  as 
possible  on  the  internal  surface  of  the  thigh,  and  thus  exploring  the 
neighbourhood  of  the  luxation. 

Diagnosis.  The  position  which  the  animal  assumes  when  one 
endeavours  to  make  it  rise  is  characteristic.  Diagnosis  of  progressive 
luxation,  however,  is  more  difficult. 

Prognosis.  The  prognosis  is  extremely  grave  ;  for,  even  though 
reduction  can  be  effected,  one  is  practically  unable  to  ensure  that  the 
parts  shall  remain  in  position. 

Treatment.  Treatment  comprises  reduction  of  the  luxation  and 
fixation  of  the  parts.  Eeduction  can  be  effected  without  very  much 
difficulty  by  casting  the  animal  on  the  affected  side,  placing  a  block 
of  wood,  or  a  pail,  between  the  thighs,  and  manoeuvring  the  limb 
in  the  desired  direction.  Ah,  however,  subluxation  is  the  condition 
most  commonly  seen,  there  is  frequently  no  reduction  to  effect.  More- 
over, fixation  of  the  joint  after  reduction  is  almost  impossible  in  such 
heavy  subjects,  and  luxation  is  very  liable  to  recur.  From  an  economic 
standpoint,  slaughter  is  advisable  or  imperative. 

LUXATION    OF    THE    PATELLA. 

Luxation  of  the  patella  is  not  uncommon  in  working  oxen,  and  is 
occasionally  seen  in  cows  as  the  result  of  a  slip  when  entering  or  leaving 
the  byre,  the  reason  being  the  peculiar  anatomical  arrangement  of  the 
femoro-patellar  articulation. 

The  internal  lij)  of  the  trochlea  of  the  femur  is  very  high,  the  external, 
on  the  other  hand,  being  only  slightly  developed.  The  patella  itself  is 
smaller  than  that  of  the  horse,  and  possesses  a  small  cartilaginous 
prolongation,  principally  on  its  inner  face,  in  marked  contrast  with  the 
large  cartilage  found  in  the  horse.  As  in  the  latter  animal,  the  out- 
ward displacement  of  the  patella  is  only  prevented  by  the  internal  patellar 
ligament  and  the  femoro-patellar  aponeurosis.  Under  the  influence  of 
varying  causes  to  which  the  joint  is  exposed,  these  supporting  structures 
often  prove  insufficient  to  prevent  the  patella  being  displaced  outwardly. 

Causation.  From  an  anatomical  standpoint,  luxation  inwards  seems 
impossible.  It  certainly  must  be  very  rare  and  be  preceded  by  rupture 
of  the  external  ligament.     On  the  other  hand,  as  in  the  horse,  it  seems 


LUXATION   OF   THE   PATELLA.  59 

l^ossible  that  the  patelhi  may  be  caught  on  the  summit  of  the  internal  hp 
of  the  trochlea,  especially  if  the  trochlea  happens  to  present  a  flattening 
at  that  point. 

Outward  luxation  may  be  spontaneous  or  accidental.  It  is  termed 
spontaneous,  when  produced  by  relaxation  of  the  ligaments  of  attachment 
or  by  irregular  muscular  action  ;  accidental,  when  resulting  directly  from 
any  external  mechanical  cause.  Violent  contraction  of  the  triceps  cruralis, 
by  lifting  the  patella  beyond  its  normal  limit  of  travel,  helps,  or  at  least 
permits,  the  patella  to  be  displaced  outwardly  at  the  moment  when  the 
muscle  relaxes. 

Pathological  relaxation  of  the  ligaments  and  muscles,  b}^  allowing  the 
patella  to  descend  too  far  on  the  trochlea,  also  renders  displacement 
possible,  hence  spontaneous  luxation  sometimes  occurs  even  while  the 
animal  is  at  rest  in  the  stable.  This  luxation  is  certainly  only  of  a 
temporary  character,  or  perhaps  only  of  the  nature  of  subluxation,  and 
is  often  reduced  by  mere  muscular  contraction  when  the  animals  are 
forced  to  move. 

Should  the  hind  limb  slip  in  a  backward  direction  the  angle  of  the 
joint  becomes  more  obtuse  and  the  lips  of  the  trochlea  are  turned  down- 
wards, thus  greatly  favouring  lateral  displacement  of  the  patella,  which 
under  these  circumstances  is  no  longer  immobilised  on  the  trochlear 
pulley ;  displacement  outAvards  then  occurs,  constituting  the  condition 
termed  luxation. 

Various  forms  of  mechanical  violence,  like  blows,  collisions  of  the  stifle 
with  the  jambs  of  doors,  falls,  etc.,  may  also  bring  about  this  luxation. 

The  symptoms  of  fully-developed  accidental  luxation  are  charac- 
teristic. Immediately  the  accident  occurs,  the  limb  is  immobilised  in  a 
state  of  complete  extension  ;  neither  the  stifle  nor  the  hock  joint  can  be 
flexed,  and  only  the  fetlock  joint  retains  any  degree  of  mobility. 

Movement  is  very  difticult.  The  hind  limb  appears  rigid,  as  though 
formed  of  one  bone.  The  pastern  is  directed  backwards  and  dragged 
along  the  ground,  and  when  weight  is  placed  on  the  limb  the  anterior 
surface  of  the  pastern  may  almost  be  in  touch  with  the  ground.  The 
limb  is  advanced,  but  the  foot  cannot  be  placed  properly  on  the  ground. 

Locally  the  patella  is  found  to  be  outside  the  external  lip  of  the 
trochlea,  and  its  internal  ligaments  are  extremely  tense. 

If  the  luxation  is  spontaneous  and  of  muscular  origin,  or  a  consequence 
of  relaxation  of  the  tendons,  it  is  usually  noticeable  immediately  the 
animal  leaves  the  stall.  The  animal  cannot  move  without  great  difiiculty. 
It  grows  steadily  worse  with  the  lapse  of  time,  because  the  synovial  mem- 
brane becomes  irritated  and  chronic  arthritis  is  set  up. 

The  symptoms  are  identical  with  those  of  traumatic  luxation,  but  are 
only  temporary. 


60        DISEASES    OF   THE   SYNOVIAL   MEMBRANES   AND    ARTICULATIONS. 

Diagnosis.  The  position  of  the  hmb  and  the  displacement  of  the 
patella  are  sufficiently  distinctive  to  render  diagnosis  fairly  easy,  and  to 
allow  of  this  accident  being  differentiated  from  luxation  of  the  femoro- 
tibial  joint  or  hooking  of  the  patella  in  the  ischio-tibial  muscle. 

Prognosis.  The  prognosis  varies  greatly.  If  the  luxation  is  of 
traumatic  origin  and  the  accompanying  symptoms  are  not  grave,  reduc- 
tion may  be  followed  by  permanent  recovery.  On  the  other  hand,  in 
spontaneous  luxation  recurrence  is  almost  inevitable. 

Treatment.  The  indications  for  treatment  may  be  comprised  in  a 
single  phrase  :  reduction,  with  immobilisation  of  the  parts  for  a  suffi- 
cient time.  To  effect  reduction,  a  strip  of  webbing  is  fixed  around  the 
pastern  of  the  affected  limb,  passed  over  the  withers,  in  front  of  the 
shoulder  of  the  opposite  side,  and  brought  round  in  front  of  the  neck  or 
between  the  front  limbs.  By  means  of  this  an  assistant  exercises  strong 
traction  on  the  limb  until  the  fetlock  is  raised  as  high  as  the  elbow  of  the 
same  side.     The  operator  then  applies  strong  inward  pressure  to  the 


Fig.  22. — Bandage  for  luxation  of  the  patella. 

patella,  which  usually  slips  back  on  to  the  gliding  surface  of  the  trochlea 
at  the  first  or  second  effort. 

After-treatment  comprises  the  application  of  a  smart  blister,  produc- 
ing oedematous  infiltration  of  all  the  tissues  around  the  joint,  and  thus 
impeding  movement  and  recurrence  of  luxation.  For  this  purpose  various 
preparations  are  used — e.g.,  cantharides,  biniodide  of  mercury,  croton 
oil,  etc.  It  is  also  advisable  to  fix  the  animal  so  that  for  a  time  it  cannot 
lie  down,  and  to  secure  the  pastern  to  the  neck  by  means  of  a  side-line. 

As  an  experiment,  cases  of  simple  fixation  of  the  patella  on  the  summit 
of  the  internal  lip  of  the  trochlea  might  be  treated  by  Bassi's  method — 
i.e.,  subcutaneous  division  of  the  internal  lateral  ligament  of  the  patella 
which  holds  the  bone  in  its  abnormal  position. 

Finally,  in  spontaneous  luxation,  occurring  in  young  animals  in  which 
blisters  have  been  inefi'ectually  tried  after  reduction,  Benard's  bandage 
may  be  used,  though  it  is  not  generally  regarded  as  very  practical.  It 
consists  of  a  piece  of  cloth  of  elongated  lozenge  form  about  four  feet 
in  length,  six  inches  in  breadth  at  its  centre  and  two  inches  at  its  ends. 
Its  centre  is  pierced  by  a  transverse  opening  intended  to  surround 
the  patella,  and  carries  a  loop  for  the  purpose  of  supporting  the  turns  of 
bandage.  A  second  longitudinal  opening  is  situated  about  eight  inches 
from  the  centre. 


LUXATION    OF    THE    FEMORO-TIBIAL    ARTICULATION. 


61 


Eeduction  being  effected,  the  whole  region  of  the  stifle  joint  is  covered 
with  Burgundy  or  ordinary  pitch  and  the  bandage  then  appHed.  The 
patella  projects  through  the  central  opening.  The  end  A  is  passed 
backwards  around  the  thigh,  and  through  the  aperture  B ;  the  two  cross 
ends  are  then  brought  forward,  crossed  again  at  the  end,  the  loop  over 
the  patella  carried  a  second  time  backwards,  again  crossed,  and  finally 
fixed  in  front  under  the  patella.  The  bandage  should  be  firmly  applied, 
without,  however,  being  so  tight  as  to  interfere  with  circulation,  and  must 
be  left  in  place  from  eight  to  ten  days. 

Van  Denmoegdenberg  recommends  placing  the  patient  on  an  inclined 
plane,  with  the  hind  quarters  a  foot  higher  than  the  front,  so  as  to  cause 
permanent  contraction  of  the  anterior  muscles  of  the  quarter,  and  thus 


Fig.  23. — Backward  luxation  of  the  feiiioro -tibial  joint, 
by  Professor  Besnoit.) 


(From  a  photograph 


immobilise  the  patella.  Simple  cold  baths,  frequently  repeated,  friction 
with  camphorated  alcohol  or  essence  of  turpentine,  complete  this  original 
but  somewhat  questionable  treatment,  and  are  said  to  result  in  recovery 
in  a  fortnight. 


LUXATION    OF    THE    FEMORO-TIBIAL    ARTICULATION. 

This  form  of  luxation  is  rare,  a  fact  explained  by  the  strength  of  the 
lateral  ligaments  of  the  joint,  and  of  the  cruciform  interosseus  ligaments. 
It  may  assume  different  forms,  according  as  the  head  of  the  tibia  is  dis- 
placed in  front  of,  behind,  to  the  inside,  or  to  the  outside  of  the  lower 
extremity  of  the  femur.  In  all,  therefore,  it  may  appear  in  four  different 
forms.     The  commonest  is  backward  luxation. 


62        DISEASES   OF   THE    SYNOVIAL   MEMBRANES    AND   ARTICULATIONS. 


Causation.  AVitli  the  sole  exception  of  luxations  or  subluxations 
due  to  tuberculosis  (lateral  luxations,  either  inwardly  or  outwardly, 
occurring  during  tubercular  arthritis,  Avith  more  or  less  marked  destruction 
of  the  condyles),  these  luxations  are  always  accidental  or  the  result  of 
mechanical  violence. 

They  result  from  leaping  into  hollows,  falling  into  deep  ditches  or 
ravines,  or  galloping  through  broken  or  steep  places.  Any  violent  shock 
affecting  the  femur,  either  in  front  or  from  the  outside,  is  capable  of 
causing  luxation  l)ackwards  or  inwards. 

Symptoms.  The  most  frequent  condition  is  backward  luxation  of  the 
upper  extremity  of  the  tibia.  Movement  becomes  difficult,  the  limb 
is  held  rigidly,  and  all  the  lower  part  of  the 
leg  is  extended.  None  of  the  joints  can  be 
flexed.  The  leg  is  dragged  forward,  without 
the  animal  being  able  to  place  the  foot  flat  on 
the  ground,  and  the  claws  are  trailed  over  the 
litter  or  the  toe  grazes  the  soil. 

On  local  examination  the  stifle  is  seen  to  be 
deformed.  The  lower  extremity  of  the  femur 
and  the  patella  appear  prominent.  The  upper 
part  of  the  tibia  is  thrust  backwards,  and  seems 
to  have  disappeared,  leaving  a  depression  below 
the  femoro-patellar  region.  The  muscles  form- 
ing the  back  of  the  thigh  at  this  level  are 
thrust  out  of  position,  and  appear  to  project 
abnormally. 

Yiewed  from  behind,  the  inner  line  of  the 
thigh  appears  more  or  less  convex  when  the 
upper  extremity  of  the  tibia  is  luxated  inwardly. 
On  local  examination  the  displacement  of  the 
bones  can  be  readily  detected.  In  luxation 
forwards  the  prominence  of  the  stifle  is  caused  by  the  summit  of  the 
tibial  crest  and  by  the  patella,  whilst  the  lower  extremity  of  the  femur 
cannot  be  felt.  In  outward  luxation  the  upper  extremity  of  the  tibia 
forms  an  abnormal  prominence,  above  which  a  horizontal  digital 
depression  appears. 

Diagnosis.  Provided  that  the  examination  is  made  soon  after  the 
occurrence  of  the  accident,  little  difficulty  will  be  found  in  coming  to  a 
conclusion,  but  the  diagnosis  necessitates  more  care  when  examination  is 
deferred  for  two  or  three  days,  because  extensive  efi'usion  then  exists. 
Luxations  or  subluxations  of  tuberculous  origin  are  generally  consecutive 
to  old-standing  destructive  tuberculous  arthritis. 

The  prognosis  is  grave — firstly,  because  reduction  is  difficult;  and. 


Fig.  24.— Luxation  back- 
wards and  inwards  of  the 
femoro-tibial  joint.  (From 
a  photograph  by  Professor 
Besnoit.) 


LUXATION    OF    THE    SCAPULO-HUMERAL   JOINT.  63 

secondly,  because  it  is  often  impossible  to  maintain  the  reduction  and  to 
preserve  complete  immobilisation  of  the  injured  joint. 

Treatment  should  not  l)e  undertaken  except  in  young  animals  which 
have  not  yet  attained  full  development. 

In  attempting  to  reduce  outward  or  inward  luxation  of  the  tibia  the 
animal  should  be  cast  on  the  side  opposite  to  the  lesion.  Counter- 
extension  is  practised  by  passing  a  length  of  webbing  around  the  limb  in 
the  region  of  the  groin ;  extension  in  the  direction  of  the  length  of  the 
femur  by  means  of  a  loop  of  webbing  fixed  to  the  cannon  bone :  the 
operator  uses  both  hands  in  endeavouring  to  replace  the  head  of 
the  tibia. 

In  forward  luxation  of  the  tibia  counter- extension  is  effected  by 
means  of  a  loop  of  webbing  passed  above  the  hock  and  drawn  forward. 
Extension  is  made  backwards  in  an  oblique  direction,  the  operator  again 
being  left  free  to  effect  reduction  with  both  hands. 

Eeduction  of  backward  luxation  of  the  tibia  is  still  more  difficult,  in 
consequence  of  the  contraction  of  the  mass  of  muscle  at  the  back  of 
the  thigh. 

Plaster  bandages  are  the  most  convenient  means  of  immobilising  the 
parts  after  reduction. 

LUXATION    OF    THE    SCAPULO-HUMERAL    JOINT. 

This  luxation,  like  that  of  the  femoro-tibial  articulation,  is  exceptional. 
It  may  assume  one  of  two  forms,  depending  on  whether  the  head  of  the 
humerus  is  displaced  inwardly,  or  towards  the  back  of  the  glenoid  cavity ; 
but  as  a  rule  luxation  occurs  inwardly.  Forward  luxation  of  the  head 
of  the  humerus  is  almost  impossible,  in  consequence  of  the  resistance 
offered  by  the  tendons  of  the  flexor  brachii  and  antea  spinatus  muscles. 
Similarly,  luxation  outwards  is  very  difficult,  the  tendon  of  the  postea 
spinatus  being  very  powerful  and  offering  enormous  resistance. 

Inwardly,  on  the  other  hand,  the  insertion  of  the  subscapularis  is 
much  less  powerful,  and  there  is  no  real  opposition  to  movement  of  the 
head  of  the  humerus. 

Causation.  Violent  meclianical  shocks  transverse  to  the  upper  third 
of  the  arm  may,  by  sheer  force,  displace  the  head  of  the  humerus  in  an 
inward  direction,  causing  rupture  of  the  internal  wall  of  the  capsular 
ligament  and  of  the  subscapularis  muscle.  Jumping  from  high  to  low 
ground  and  falling  on  the  front  limbs  tend  to  displace  the  glenoid  cavity 
in  front  of  the  head  of  the  humerus,  and  often  result  in  luxation  of  the 
bone  in  a  backward  direction,  a  luxation,  however,  which  almost  always 
assumes  a  postero-internal  direction.  The  commonest  causes  of  these 
luxations   are    the  sideward  falls  of   animals  which  have  attempted  to 


61        DISEASES   OF   THE    SY.VOVIAL   MEMBRANES   AND   ARTICULATIONS. 

cover  others.  Whether  the  subject  be  a  bull  or  a  cow,  if  the  stationary 
animal  suddenly  moves  to  one  side,  or  if  the  moving  animal  is  frightened 
by  the  appearance  of  a  dog,  one  of  the  front  limbs  may  be  violently 
dragged  away  from  the  body  ;  the  resistance  of  the  capsular  ligament 
and  internal  muscles  of  the  shoulder  may  be  overcome  and  luxation 
produced. 

Symptoms.  Symptoms  are  immediately  apparent :  no  weight  can  be 
placed  on  the  injured  limb,  and  the  animal  moves  on  three  legs.  All 
muscular  action  is  avoided,  the  limb  is  slightly  shortened  as  a  conse- 
quence of  the  head  of  the  humerus  slipping  behind  the  shoulder,  which 
is  held  rigidly  during  movement ;  the  points  of  the  claws  are  dragged 
along  the  ground. 

On  local  examination  the  point  of  the  shoulder  appears  to  be  deformed 
and  outwardly  displaced,  in  consequence  of  the  pressure  exercised  by  the 
displaced  head  of  the  humerus.  Below  the  glenoid  cavity  and  coracoid 
process  lies  a  depression,  at  the  base  of  which  the  displaced  humerus 
can  be  felt.  This  depression,  however,  is  soon  filled  up  by  the  sero- 
sanguinolent  effusion  consequent  on  luxation. 

Diagnosis.  Bearing  in  mind  the  conditions  to  which  the  accident  is 
due,  the  diagnosis  presents  no  great  difficulty. 

Prognosis.  The  prognosis  is  grave,  for  although  it  is  relatively  easy 
to  reduce  the  displacement,  it  is  very  difficult  to  keep  the  joint  fixed 
in  position. 

Treatment.  To  effect  reduction,  the  animal  should  be  cast  on  the 
sound  side,  and  a  loop  of  webbing  passed  under  the  arm,  in  order  to 
provide  for  counter-extension.  The  limb  is  extended  by  direct  traction 
on  the  cannon  bone  or  fetlock,  whilst  the  operator  endeavours  to  effect 
reduction  with  one  hand  placed  in  front  and  one  behind  the  joint. 

In  young  animals  of  trifling  weight  immobilisation  may  be  attempted, 
the  best  method  being  the  application  of  pitch  plasters.  If,  on  the  other 
hand,  the  subject  is  heavy,  there  is  so  great  a  chance  of  displacement 
when  lying  down  and  rising,  that  such  cases  are  usually  sent  to  the 
butcher,  or  abandoned  to  chance.  Eelative  recovery,  sufficient  to  permit 
of  growth  or  fattening,  may  take  place  without  professional  assistance. 

IV.— HYGEOMAS. 

Hygromas  result  from  chronic  inflammation  of  serous  bursfe,  naturally 
existing,  or  of  serous  burspe  which  form  at  prominent  points  where  the 
skin  is  exposed  to  repeated  friction,  blows,  shocks,  or  over-extension. 

They  usually  develop  slowly,  without  producing  marked  pain  or 
alarming  symptoms,  and  therefore  the  practitioner  is  seldom  consulted 
until  the  swelling  has  attained  a  considerable  size. 


HYGROMA   OF   THE    KNEE. 


65 


The  hygroma  is  usually  characterised  by  its  non-painful  character 
and  by  regular  fluctuation  throughout.  The  walls  of  the  serous  bursas 
are  merely  thickened,  so  that  palpation  is  easy. 

Should  the  hygroma  become  infected  and  inflamed,  it  assumes  the 
same  characters  as  an  abscess :  it  becomes  highly  sensitive,  is  surrounded 
by  oedematous  infiltration,  shows  more  marked  fluctuation  at  some 
specialised  point,  and  eventually  breaks,  discharging  pus. 

Long-standing  hygromas    often  have   thickened   fibro-cartilaginous 
and  extremely  hard  walls,   which  render 
examination  more  difficult. 

Where  the  hygroma  is  much  exposed 
to  friction  the  skin  covering  it  undergoes 
complete  transformation,  the  layers  of 
epidermis  becoming  converted  into  a 
substance  resembling  horn.  The  entire 
substance  of  the  wall  of  the  hygroma  then 
undergoes  change,  and  is  often  infiltrated 
with  lime  salts  or  encrusted  with  plates  of 
bone  of  varying  thickness. 

HYGROMA    OF    THE    KNEE. 

This  condition  is  very  common  in 
bovines,  a  fact  explained  by  the  manner 
in  which  these  animals  rise.  Whilst  the 
hind  limbs  are  being  lifted,  the  entire 
burden  of  the  body  weight  is  transmitted 
to  the  knees  and  the  tissues  covering  them ; 
so  that,  if  the  ground  is  rough,  the  skin  may 
be  sufficiently  displaced  to  produce  lacera- 
tion of  the  subcutaneous  connective  tissue, 
serous  efl'usion  in  the  layers  of  connective 
tissue,  and  the  immediate  production  of 

an  hygroma  beneath  the  skin  and  in  front  of  the  synovial  sheaths  of 
the  extensor  tendons. 

Hygroma  is  principally  caused  by  falls  on  the  knees,  roughness  of  the 
stable  floor,  prolonged  decubitus  during  the  course  of  a  serious  disease, 
or  after  an  attack  of  foot-and-mouth  disease. 

Hygromas  may  be  no  larger  than  a  turkey's  egg  or  a  man's  clenched 
fist,  but  sometimes  assume  the  dimensions  of  a  child's  head.  Calcifica- 
tion and  ossification  of  the  walls  and  cornification  of  the  skin  are 
commonest  in  old  hygromas  of  the  knee. 

The  sensibility  and  uniform  fluctuation  make  mistakes  in  diagnosis 

D.C.  F 


Fig.  25.  —  Old-standing  hygroma 
of  the  knee.  PE,  external  coat; 
CC,  cornified  coat ;  CO,  osseous 
coat ;  CP,  pus  cavity ;  PI,  internal 
coat. 


()(j        DISEASES    OF    THE    SYNOVIaL    MfeMBRAiNES    AM)    ARTlCULATtONS. 


difficult.  The  condition  can  only-  be  confused  with  distension  of  the 
synovial  sheath  of  the  extensor  metacarpi  magnus  ;  but  this  (synovial) 
swelling  extends  in  the  same  direction  as  the  tendon,  i.e.,  vertically, 
attains  the  lower  third  of  the  radius,  and  is  broadest  above.  Hygromas 
must  also  be  distinguished  from  tumours.  Moussu  only  mentions  a 
single  case  of  this  kind,  the  tumour  l)eing  very  slightly  l)Osselated  and, 
naturally,  revealing  no  fluctuation. 

The  prognosis  is  not  grave,  though  the  condition  may  prove  trouble- 
some, because  the  original  injuries  may  be  continued  even  during  treat- 
ment and  prevent  recovery. 

Treatment.  Success  rarely  follows 
cold  applications  or  l)listering,  which 
are  only  of  value  at  the  commence- 
ment. It  is  better  to  puncture  the 
cavity  aseptically,  remove  the  fluid 
contents,  and  fire  the  grow^th  in  points. 
Free  opening  of  the  lowest  portion  of 
the  swelling  is  followed  by  discharge 
of  liquid,  but  almost  inevitably  by  iur 
fection  at  a  later  stage,  and  by  suppu- 
ration. Eecovery  certainly  may  occur, 
a  slight  thickening  of  the  anterior 
surface  of  the  knee  remaining ;  but 
the  process  is  often  very  prolonged. 
Home  authors  prefer  to  pass  a  seton  or 
drain  vertically  through  the  swelling. 
The  results  are  identical  with  those 
following  free  opening  and  drainage, 
suppuration  being  unavoidable. 

If  the  animal  be  sufficiently  valu- 
able to  warrant  surgical  intervention, 
the  entire  hygroma,  together  with  its 
indurated  wall,  may  be  excised.  An 
elliptical  fragment  of  skin  is  removed  from  the  front  of  the  swelling,  and 
the  whole  mass  .separated  by  dissecting  away  or  tearing  through  the  connec- 
tive tissue.  Considerable  care  is  necessary  to  avoid  injuring  the  synovial 
sheaths  of  the  extensor  tendons.  This  treatment,  which  is  only  applicable 
in  valuable  animals,  is  completed  by  firmly  suturing  the  lips  of  the  w^ound, 
and  applying  an  antiseptic  surgical  dressing  or  a  plaster  bandage  similar 
to  that  used  in  operating  on  broken  knees  in  horses.*  The  animal  must 
be  prevented  from  lying  down  until  the  wound  has  firmly  united. 

*  See   Dollar's   "A   Surgical   Operating  Table  for  the  Horse."     (London:    Gay 
and  IHrd.) 


Fig.  26. — Hygroma  of  the  knee.  The 
skin  has  undergone  conversion  into 
a  substance  resembling  horn. 


Hygroma  of  the  stifle.  67 

HYGROMA    OF    THE    HAUNCH. 

With  the  exception  of  hygroma  of  the  knee,  hygromas  are  commoner 
on  hind  than  on  front  Hmbs.  That  of  the  haunch  is  Hmited  to  the 
external  angle  of  the  ilium.  It  follows  violent  falls  or  collisions  with 
door  posts,  and  results  from  laceration  of  the  layers  of  subcutaneous 
connective  tissue  and  separation  of  the  skin  from  subjacent  parts. 

The  effusion  is  often  of  a  sero-sanguinolent  character.  It  is  more 
frequent  in  animals  occupying  narrow  or  irregularly  shajDed  stalls,  the 
hygroma  being  developed  through  repeated  collision  of  the  angle  of  the 
haunch  with  the  wall.     Finally,  it  may  follow  prolonged  decubitus. 

Diagnosis  is  easy,  but  the  prognosis  has  a  certain  element  of  gravity, 
because,  should  suppuration  occur,  it  may  be  succeeded  by  necrosis  of 
the  aponeurosis  inserted  into  the  external  angle  of  the  ilium. 

Treatment  should  first  be  directed  to  removing  the  cause.  Of  the 
various  modes  of  intervention,  the  best  probably  consists  in  disinfecting 
the  parts,  puncturing  the  swelling,  and  injecting  some  irritant  of  an 
antiseptic  character,  or  simply  washing  out  the  cavity.  Iodine  and 
carbolic  solutions  are  most  commonly  employed.  Firing  is  contra- 
indicated. 

HYGROMA    OF    THE    TROCHANTER    OF    THE    FEMUR. 

This  condition  is  rare,  except  in  thin  milch  cows  kept  under  bad 
hygienic  conditions  and  insufficiently  supplied  with  bedding.  Continual 
bruising  of  the  prominences  of  the  quarters  whilst  the  animal  is  lying 
is  the  usual  cause. 

This  hygroma  forms  a  hemispherical  swelling  covering  the  trochanteric 
prominence.     Movement  is  interfered  with,  and  the  stride  is  shortened. 

The  condition  can  only  be  confused  with  the  diffuse  swellings  due  to 
periarthritis  in  the  coxo-femoral  region,  which  frequently  occur  in  cows 
suffering  from  infectious  pseudo-rheumatism. 

The  prognosis  is  somewhat  grave,  for  in  case  of  suppuration  the 
insertions  of  tendons  and  fascia  into  the  summit  of  the  trochanter  may 
become  necrotic. 

Treatment.  The  first  point  is  to  supply  the  animal  with  ample  clean 
bedding.  The  swelling  may  be  repeatedly  blistered.  If  considered  neces- 
sary, a  puncture  may  be  made  under  antiseptic  precautions,  the  fluid  drawn 
oft',  and  the  cavity  washed  out ;  but  it  is  better  to  avoid  opening  the  parts 
with  a  bistoury,  on  account  of  the  danger  of  suppuration  and  of  necrosis 
of  the  tendons  and  aponeurotic  tissues  in  the  neighbourhood. 

HYGROMA    OF    THE    STIFLE. 

Hygroma  of  the  stifle  or  of  the  patella  appears  under  the  skin,  outside 
the  external  ligament  of  the  femoro-tibial  articulation.     It  usually  follows 

F  2 


OS        DISEASES   OF   THE   SYNOVIAL   MEMBRANES   AND   ARTICULATIONS. 


repeated  abrasion  when  l^'ing  do\Yn,  especially  if  the  paving  of  the  stalls 
is  rough  or  irregular. 

The  swelling  varies  in  size  from  a  hen's  egg  up  to  that  of  a  child's 
head,  and  exhibits  fluctuation  throughout. 
'  The   prognosis   is   somewhat   serious,  for 

liere    again    complications    may    result    from 
necrosis  of  neighbouring  aponeuroses. 

Some  authors  recommend  passing  a  seton 
dressed  with  some  irritant  material  through  the 
swelling.  Aseptic  puncture,  however,  seems 
preferable,  followed  by  washing  out  of  the 
cavity  and  the  application  of  a  blister. 

HYGROMA    OF    THE    POINT    OF    THE 
HOCK. 


This  hygroma  usually  results  from  blows 
with  the  ox-goad,  which  cause  inflammation 
of    the    subcutaneous   connective   tissue   and 
oedematous  infiltration  extending  down  the  leg.     Afterwards  the  slightest 


Fiu.  27. — Capped  hock. 


Fig.  28. — Hygroma  of  the  point  of  the  sternum. 


injury,  or  even  the  friction  due  to  the  animal  lying  down,  causes  liquid 
to  collect  and  an  hygroma  to  form. 

This  hygroma  is  readily  infected  and  often  suppurates ;  it  then 
becomes  very  sensitive,  producing  intense  lameness.  More  frequently, 
however,    under    the    influence    of    prompt    treatment,    the    liquid    is 


HYGROMA    OF   THE    POINT    OF    THE    STERNUM.  69 

absorbed,  the  layers  of  subcutaneous  connective  tissue  become  hardened, 
and  undergo  more  or  less  extensive  induration. 


HYGROMA    OF    THE    POINT    OF    THE    STERNUM. 

Hygroma  of  the  point  of  the  sternum  is  a  rarity.  It  only  occurs 
in  thin  animals  in  which  the  jjoint  of  the  sternum  is  prominent,  and 
which  are  confined  to  stables  with  rough  floors  and  provided  with 
insufficient  bedding. 

The  swelling  should  not  be  opened,  for  the  tissues  in  front  of  the 
sternum  readily  become  the  seat  of  suppuration. 

If  treatment  is  desirable,  the  fluid  may  be  drained  off  by  means  of  an 
aseptic  puncture. 


CHAPTER    IV. 
DISEASES    OF    MUSCLES    AND    TENDONS. 

RUPTURE    OF    THE    EXTERNAL    ISCHIO-TIBIAL    MUSCLE 
(BICEPS    FEMORIS). 

The  l)iceps  femoris  muscle  extends  from  the  superior  spinous  process 
of  the  sacrum  to  the  region  of  the  patella  and  the  external  surface  of 
the  thigh,  Ahove,  it  is  inserted  into  the  sacrum  and  the  posterior 
margin  of  the  ischium,  helow  into  the  supero-external  surface  of  the  tibia. 
It  completely  covers  the  coxo-femoral  articulation,  and  its  passage  over 
the  summit  of  the  trochanter  is  lubricated  by  a  serous  bursa.  The  whole 
of  its  anterior  margin  is  connected  with  the  fascia  lata  by  an  aponeurotic 
expansion.  From  varying  causes  this  aponeurotic  layer  may  become 
fissured ;  during  the  backward  and  forward  movements  of  the  limb  the 
summit  of  the  trochanter  may  enter  the  fissure  and  become  fixed  there 
l)y  the  tension  and  resistance  of  neighbouring  tissues.  This  accident 
has  been  descrilied  as  "  displacement  or  rupture  of  the  biceps  femoris 
muscle." 

According  to  Cruzel,  fixation  of  the  biceps  femoris  may  occur,  in  very 
thin  animals,  without  rupture  of  the  musculo-aponeurotic  layer,  the 
process  being  then  simply  confined  to  stretching  of  the  aponeurotic  layer 
over  the  summit  of  the  trochanter.  Under  such  circumstances  the 
musculo-aponeurotic  layer  presents  a  cup-like  depression,  into  which  the 
summit  of  the  trochanter  fits,  and  thus  effectually  prevents  movement  of 
the  muscle. 

Whether  the  accident  is  due  to  an  actual  fissure,  or  only  to  stretching 
of  the  aponeurosis,  the  symptoms  are  the  same. 

Causes.  The  principal  predisposing  causes  are  thin  condition  and 
malformation  of  the  limbs  (turning  outward  of  the  hind  toes). 

The  accident  may  occasionally  be  caused  by  a  slip  backwards,  or  by 
extreme  efforts  in  draught  when  ascending  hills. 

Symptoms,  hnmediately  the  accident  occurs  the  liml)  becomes  fixed 
in  a  position  of  maximal  extension.  The  trochanter  being  caught,  the 
femur  can  no  longer  be  flexed,  and  the  lower  joints  are  also  fixed  in 
such  a  way  that  the  limb  can   only  be  moved  as  a  whole.     The  claws 


RUPTURE  OF  THE  EXTERNAL  ISCHIO-TIRIAL  MUSCLE  (BISCEPS  FEMORIS).      71 

are  dragged  along  the  ground,  and  the  affected  limh,  which  can  never  be 
completely  advanced,  is  brought  forward  with  a  mowing  movement. 

On  local  examination,  the  trochanter  appears  to  be  very  prominent, 
and  situated  directly  above  a  rigid  cord  which  extends  parallel  with 
the  anterior  margin  of  the  affected  muscle. 

If  the  accident  consists  merely  in  the  formation  of  a  depression  in 
the  muscle,  in  which  the  summit  of  the  trochanter  is  fixed,  and  if  there 
is  no  Assuring,  the  muscle  and  the  femur  are  certainly  immobilised,  but 


Fig.  29. — Arrangement  of  the  external  ischio-tibialis  muscle.     1,  Anterior 
margin  of  the  muscle  ;  2,  fascia  lata. 


the  limlj  can  be  moved  to  a  certain  extent,  the  "  mowing  "  movement  is 
less  marked,  and  there  is  no  well-defined  rigid  cord  along  the  anterior 
margin  of  the  muscle. 

Diagnosis.  The  condition  can  only  be  confused  with  luxation  of  the 
patella ;  l)ut  manual  examination  of  the  affected  parts  revealing  the 
presence  of  a  rigid  cord  l)elow  the  trochanter  at  once  removes  any 
doul)t. 

Prognosis.  The  prognosis  is  only  grave  in  working  animals.  More- 
over, the  accident  is .  now  much  rarer  than  formerly,  if  only  because 
animals  are  better  looked  after  and  better  fed. 

Treatment.  If  the  accident  results  simply  from  the  formation  of  a 
depression  in  the  musculo-aponeurotic  layer  which  replaces  the  muscle 


72  DISEASES   OF   MUSCLES    AND   TENDONS. 

at  the  point  where  it  passes  over  the  trochanter,  there  is  nothing  to  be 
done.  Eeduction  will  occur  spontaneously,  and  entire  liberty  of  action 
will  be  regained.  Cruzel  states  that  it  is  sometimes  sufficient  to  force 
the  animal  to  move  down  a  slope,  in  order  to  withdraw  the  trochanter 
from  the  depression  in  which  it  has  been  lodged,  and  to  restore  its 
normal  mobilit}-. 

Eest  and  good  feeding  favour  the  deposition  of  fat,  and  soon  alter 
the  conditions  responsible  for  the  accident ;  the  muscles  of  the  quarter 
become  surrounded  with  fat,  the  external  ischio-tibial  muscle  (biceps 
femoris)  is  thrust  outwards  on  account  of  its  superficial  position,  and 
then  cannot  be  ruptured  by  the  summit  of  the  trochanter.  If,  on  the 
other  hand,  the  musculo-aponeurotic  layer  is  fissured  and  the  summit  of 
the  trochanter  firmly  fixed  in  the  opening,  oj^eration  becomes  necessary. 
This  consists  in  incising  the  anterior  margin  of  the  muscle  over  the 
afore-mentioned  rigid  cord.  The  margins  of  the  wound  retract,  the 
tension  of  the  cord  is  diminished,  the  trochanter  released,  and  the 
normal  play  of  the  limb  restored. 

Numerous  methods  of  operation  have  been  described  and  a  numl)er 
of  special  instruments  invented.  The  earlier  methods  consisted  in  simple 
sul)cutaneous  section  of  the  rigid  cord  formed  by  the  musculo-aponeurotic 
layer  and  the  muscle.  Subcutaneous  section  is  carried  out  exactly  like 
tenotomy,  using  straight  and  curved  tenotomes.  The  seat  of  operation 
is  about  three  inches  below  the  summit  of  the  trochanter.  In  the 
absence  of  tenotomes,  section  may  be  performed  with  a  bistoury  intro- 
duced from  below  the  muscle  by  means  of  a  grooved  director,  which  has 
been  inserted  through  a  cutaneous  puncture  made  at  the  point  indicated 
over  the  anterior  margin  of  the  prominent  cord. 

In  better  nourished  subjects,  in  which  this  cord  is  less  prominent, 
the  operator  may,  to  ensure  greater  accuracy,  make  a  vertical  incision 
an  inch  or  two  in  length  at  the  point  selected  over  the  anterior  margin 
of  the  muscle,  isolate  this  muscle  by  means  of  the  director;  and  after- 
wards perform  the  section.  Considerable  hfemorrhage  occasionally 
follows  division  of  some  small  muscular  vessel,  but  is  of  no  consequence 
unless  the  wound  has  been  infected. 


RUPTURE    OF    THE    FLEXOR    METATARSI. 

The  rupture  of  this  tendon-muscle  is  exceptional,  and,  according  to  the 
description  given  by  Furlanetto,  is  attended  by  the  same  symptoms  as  in 
the  horse — i.e.,  flexion  of  the  stifle  joint  is  not  accompanied  by  flexion  of 
the  hock  or  of  the  metatarsus  on  the  til)ia.  The  cannon-bone  hangs 
vertically  when  the  liml)  is  moved. 

Eecovery  follows  prolonged  rest. 


CYSTICERCITS   DISEASE   OF   THE    PIG. 


73 


Wounds  and  sections  of  tendons  in  the  region  of  the  cannon  bone, 
sections  of  the  tendo-AchiUis,  etc.,  have  been  seen  and  described.  All 
such  injuries  may  heal  under  antiseptic  treatment  and  after  aseptic 
suture  of  the  divided  ends,  provided  the  sutures  and  dressings  are  applied 
immediately.  If,  on  the  other  hand,  suppuration,  infection,  necrosis 
of  tendons,  synovitis  or  arthritis  occur  as  complications,  such  injuries 
become  extremely  serious,  and  from  an  economic  standpoint  render  it 
better  to  sacrifice  the  animal  rather  than  attempt  treatment. 

Strains  of  tendons  and  tendinitis  occur  in  the  front  limbs  of  oxen, 
particularly  of  those  used  in  carts.  The  chief  indications  are  swelling  in 
the  region  of  the  cannon  bone  and  fetlock,  uneven  contour  of  the  flexor 
tendons,  sensibility  on  pressure,  and  lameness  of  varying  intensity. 

Treatment  consists  in  continuous  cold  irrigation,  massage,  the 
application  of  a  blister  or  even  of  the  actual  cautery.  As  a  rule,  how- 
ever, it  is  better  to  rest  and  fatten  the  animal. 

A  frequent  complication  of  such  injuries  of  tendons  consists  in 
knuckling  over  at  the  fetlock. 

PARASITIC    DISEASES    OF    MUSCLES. 


INFECTION    WITH    CYSTICERCI. 

Infection  of  the  connective  and  muscular  tissues  with  cysticerci 
results  from  the  entry  into  the  body  of  embryos  of  Tcenia  soliiun  and 
Tcenia  saginata  of  man.  It  occurs  in  man  and  almost  all  animals,  but 
is  only  of  grave  clinical  importance  in  the  pig  and  ox. 

The  following  table  shows  the  chief  cystic  (cestode)  parasites  of  animals, 
though  the  cysts  are  not  always  confined  to  muscular  structures : — 


Adult. 

Larva. 

Xame. 

Host. 

Nam  p. 

Ho.st. 

Tcmiia  saginata 
Tcenia  solium     .     . 
Tcenia  marginata  . 
Tcenia  ccenurus 
Tcenia  ecliinococcus 

Man 
I\Ian 
Dogs 
Dogs 
Dogs 

Cijsticercus  hovis    .     .     . 
Cysticercus  cellulosce . 
Cijsticercus  tenuicollis    . 
Ccxnurus  cerebralis     .     . 
Ecliinococcus     polymor- 
l)hus 

Cattle. 

Swine  and  man. 
Cattle,  sheep,  and  swine. 
Cattle  and  sheep. 
Cattle,   sheep,  swine,  man, 
etc. 

CYSTICERCUS    DISEASE    OF    THE    PIG. 

This  disease  of  the  pig  is  due  to  Cysticercus  ceUidosce,  the  cystic  form 
of  the  Tcenia  solium  or  Tcenia  armata  of  man.  As  a  disease  of  the  pig 
it  has  been  recognised  from  the  most  ancient  times,  and  is  stated  to  be 


74  DISEASES    OF    MUSCLES    AND    TENDONS. 

the  cause  of  Moses  and  Mohammed  having  prohibited  the  consumption 
of  pork  by  their  disciples.  In  the  Middle  Ages  it  formed  the  subject  of 
legislation.  It  was,  however,  only  when  the  investigations  of  Van  Beneden 
and  Kuchenmeister  had  completed  those  of  the  zoologists  of  the  seven- 
teenth and  eighteenth  centuries  that  the  evolution  of  taeniae  became  well 
known  and  the  importance  of  the  cystic  phase  clearly  established. 


ric  )0— \  piece  ot  poik 
heiMh  infected  with,  poik 
me  isles  {Cysticncus  idUi 
losa)  wxiwixX  ^i/e.  (Stiles 
Kepoit  L  S  \  Buiciu  of 
Voucnltuic   1901  ) 


Fig.  31. — An  isolated  pork-measle  bladder  woiiu  (Ci/sticcrcus 
ceUulos(c),  with  extended  head,  greatly  enlarged.  (Stiles, 
Report  U.S.A.     Bureau  of  Agriculture,  1901.) 


Causation.  The  cause  of  cysticercus  disease  in  the  pig  ma}'  be 
summed  up  in  one  phrase — viz.,  ingestion  of  eggs  or  eml)ryos  of  T<enia 
soUnm. 

Young  animals  alone  seem  to  contract  the  disease. .  After  the  age  of 
eight  to  ten  months  they  appear  almost  entirely  proof  against  it. 

It  is  very  rare  in  animals  reared  in  confinement,  but  is  relatively 


CYSTICERCUS    DISEASE    OF    THE    PIG, 


75 


common  in  those  roaming  at  liber t}' 
to  discover  human  excrement  and 
the  embryos  of  taenia.  The  eggs 
having  been  swallowed,  the  six- 
hooked  embryos  are  set  at  liberty 
in  the  intestine,  perforate  the 
tissues,  enter  the  vessels,  and  are 
carried  by  the  blood  into  all  parts 
of  the  body.  Those  alone  develop 
well  which  reach  the  interstitial  and 
intermuscular  connective  tissue. 
The  others  in  the  viscera  usually 
disappear.  Their  presence  in  the 
.depths  of  the  muscles  produces 
slight  general  disturbance  and 
signs  of  local  irritation,  due  to 
the  development  of  the  cyst  itself. 
At  the  end  of  a  month  the  little 
vesicle  is  large  enough  to  be  visible 
to  the  naked  eye ;  in  forty  to  forty- 
five  days  it  is  as  large  as  a  mustard 
seed,  and  in  two  months  as  a  grain 
of  barley.  Its  commonest  seats  are 
the  abdominal  muscles,  muscular 
portions  of  the  diaphragm,  the 
psoas,  tongue,  heart,  the  muscles 
of  mastication,  intercostal  and  cer- 
vical muscles,  the  adductors  of  the 
hind  legs,  and  the  pectorals. 

Symptoms.  The  symptoms  of 
invasion  are  so  little  marked  as 
usually  to  pass  undetected.  Occa- 
sionally, when  large  quantities 
have  been  ingested,  signs  of  en- 
teritis may  occur,  but  these  are 
generally  ascribed  to  some  entirely 
different  cause.  In  some  cases  there 
is  difficulty  in  moving,  and  the  grunt 
may  be  altered. 

Certain  authors  declare  that 
the  thorax  is  depressed  between 
the  front  limbs,  but  this  symj^tom 
is  of   no  particular  vaUie,  and   is 


because  tliey  are  mucli  more  likely 

M 


Fig  .5'2.  -Se\ei.il  poitioiis  ot  .m  adult 
porlv-iiieasie  tapeworm  (Tccnia  soltinn), 
natural  size.  (Stiles,  Report  U.S.A. 
BureaiT  of  Agriculture,  1901.) 


70 


DISEASES   OF   MUSCLES   AND   TENDONS. 


Fig.  33. — Large  (a)  and  small  (b)  hooks  of 
pork-measle  tapeworm  {Tcvnia  solium). 
X  280.     (After  Leuckart.) 


also  common  to  osseous  cachexia  and  rachitis.  Paralysis  of  the  tongue 
and  of  the  lower  jnw  is  of  greater  importance.  In  exceptional  cases,  where 
the  cj'sticerci  are  very  numerous  and  penetrate  the  hrain,  signs  of 
encephalitis,  vertigo,  and  turning  sickness  (gid,  sturdy)  may  he  produced. 
These  signs,  however,  disappear,  and  the  cysticerci  undergo  atrophy. 
Interference  with  movement  may  give  rise  to  suspicion  when  the  toes  of 

the  fore  and  hind  liml)S  are 
dragged  along  the  ground,  and 
thus  hecome  worn.  This  pecu- 
liarity is  due  to  the  presence 
of  cysts  in  the  muscles  of  the 
limhs,  hut  it  occurs  in  an  al- 
most identical  form  in  osseous 
cachexia. 

One  symptom  alone  is 
pathognomonic,  and  it  appears 
only  at  a  very  late  stage — viz.,  the  presence  of  cysts  under  the  thin 
mucous  membranes  which  are  accessil)le  to  examination,  such  as  those 
of  the  tongue  and  eye. 

Visual  examination  then  reveals 
beneath  these  mucous  membranes 
the  presence  of  little  greyish-white, 
semi-transparent  grains  the  size  of 
a  grain  of  barley,  or  even  larger. 
Unfortunately,  in  an  animal  so  diffi- 
cult to  handle  as  the  pig,  this  visual 
examination  is  decidedly  troublesome, 
and  is  usually  replaced  by  palpa- 
tion. In  many  instances  the  disease 
does  not  attract  attention  during  the 
patient's  life,  and  is  only  discovered 
on  slaughter  in  consequence  of  the 
lesions  by  which  it  is  characterised. 
Diagnosis.  As  the  characteristic 
lesions  of  cj'sticercus  disease  are 
to  be  found  in  the  depths  of  the 
muscular  and  connective  tissues,  and 
as  the  external  symptoms  may  be  regarded  as  of  doul)tful  significance, 
the  diagnosis  can  only  be  confirmed  during  life  by  manual  examination 
of  the  tongue.  This  examination  of  the  tongue  has  been  practised  since  the 
earliest  times.  Aristophanes  even  speaks  of  it,  and  in  the  Middle  Ages 
it  was  performed  under  sworn  guarantees.  The  regulations  concerning 
the  inspection  of  meat  have  finally  led  to  the  suppression  of  this  calling. 


Fig.  34. — Mature  sexual  segments  of 
pork-measle  tapeworm  ( Trt'mrt  soUtnii), 
sliowing  the  divided  ovary  on  the  pore 
side.  cp,  Cirrus  pouch ;  gp,  genital 
pore  ;  n,  nerve  ;  ov,  ovary;  t,  testicles  ; 
tc,  transverse  canal ;  iif,  uterus ;  v. 
vagina ;  vc,  ventral  canal  ;  vd,  vas 
deferens  ;  vf/,  vitellogene  gland,  x  10. 
(After  Leuckart.) 


CYSTICERCUS   DISEASE    OF   THE   PIG. 


77 


In  this  method  of  exammmg  the  tongue,  the  operator  commences  by 
throwmg  the  animal  on  its  side,  usually  on  the  right  side,  and  holding 
it  in  this  position  by  placing  his  left  knee  on  its  neck.  He  then  passes 
a  thick  stick  between  the  Jaws,  and  behind  the  tusks,  opens  the  mouth 
obliquely,  raising  the  upper  jaw  by  manipulating  the  stick.  Finally  he 
fixes  one  end  of  this  last  by  placing  his  foot  upon  it,  and  holds  the 
other  extremity  by  slipping  it  under  his  left  arm.  In  this  position  he 
is  able  to  grasp  the  free  end  of  the  tongue  and  by  digital  palpation  to 
examine  the  tongue  itself,  the  gums,  the  free  portions  of  the  fraenum 
lingufe,  etc. 

If  he  discovers  cysts,  the  diagnosis  is  confirmed,  but  failure  to  do  so 


Fig.  35. — Gravid  segment  of  pork-measle  tapeworm  [Tienia 
soZt«;«),  showing  the  lateral  branches  of  the  uterus  enlarged. 
(Stiles,  Report  U.S.A.  Bureau  of  Agriculture,  1901.) 


by  no  means  disposes  of  the  possibility  of  infection.  Eailliet  declares 
that  about  one  animal  in  four  or  five  shows  no  cysts  beneath  the  tongue, 
and,  moreover,  fraud  is  possible  in  this  connection,  it  being  quite  possible 
to  prick  the  little  cysts  with  a  needle  so  that  the  liquid  contents  escape, 
and  examination  gives  no  positive  result.  For  these  reasons  intra-vitam 
examination  alone  is  now  discounted,  and  the  chief  reliance  is  placed  on 
post-mortem  search. 

Prognosis.  The  prognosis  is  very  grave,  not  on  account  of  danger  to 
the  lives  of  the  infected,  but  because  infected  meat  may  be  offered  for 
human  consumption.  Should  such  meat,  in  an  insufficiently  cooked 
condition,  be  eaten  by  man,  its  ingestion  is  followed  by  the  development 
of  Td'nia  soUiuJi.     If  cooking  were  always  perfect  it  would  destroy  the 


^8 


DISEASES    OF   MUSCLES   AND   TENDON'S. 


cysticerci 


but  the  luicertaiiity  in  this  respect  should  prevent  such  meat 
being  consumed.  The  cysticerci  are  killed  at 
a,  temperature  of  125°  to  130°  Fahr. 

Lesions.  The  lesions  are  represented  by 
cysts  alone — i.e.,  by  semi-transparent  l)ladders, 
each  of  which  contains  a  scolex  or  head  armed 
with  four  suckers  and  a  double  crown  of  hooks. 
The  little  bladders  are  most  commonly  found 
in  the  muscles,  lodged  in  the  interfascicular 
tissue,  which  they  slightly  irritate. 

The    number    present    varies    extremely, 

depending  on  the  intensity  of  infestation  and 

the   number  of   eggs    swallowed.      Whilst  in 

to    discover,    in    others 


Fig.  36. —  Eggs  of  pork- 
ineasle  tapeworm  {Tcenia 
solmvi) :  a,  with  primi- 
tive vitelline  membrane  ; 
6,  without  primitive  vitel- 
line membrane,  but  with 
striated  embrj-ophore . 
X  450.     (After  Leuckart.) 

some    cases   difficult 
they  are   so  numerous   that   the   tissues 
ap2)ear  strewn  with  them. 

They  are  commonest  in  the  muscles 
of  the  tongue,  neck,  and  shoulders,  in 
the  intercostal  and  psoas  muscles,  and  in 
those  of  the  quarter. 

The  viscera — viz.,  the  liver,  kidneys, 
heart,  lungs,  etc. — are  less  commonly  in- 
fested, and  in  these  organs  the  cysts 
degenerate  very  rapidly.  In  animals 
which  have  been  infested  for  a  long  time, 
the  cysts  may  even  have  undergone  caseo- 
calcareous  degeneration,  the  liquid  being 
absorbed  and  the  lesions  presenting  the 
ajDpearance  of  little  oblong  firm  nodules. 

On  cutting  through  masses  of  muscle 
the  vesicles  protrude  from  between  the 
bundles. 

In  young  animals,  infestation  with 
cysticerci  causes  wasting  and  ill-health; 
subsequently  the  patients  improve  in 
ajipearance,  later  on  fatten,  and  gain 
marketable  condition. 

Of  the  carcases  examined  in  Prussian 
slaughter-houses  between  1876 — 8t2,  one 
in  every  305  was  found  infested ;  between 
1885 — 1)3,  one  in  every  537. 

Treatment.  There  is  no  curative  treat- 
ment.    Only  preventive  measures  are  of 


Fi(i.  o7. — Half  of  hog,  showing  the 
portions  most  likely  to  become 
infested  with  pork  measles. 
(After  Ostertag.) 


BEEF    MEASLES. 


Id 


value.    These  are  confined  to  rendering  it  ini})0SHil)le  for  animals  to  ingest 
eggs  of  the  Tcenia  solium. 

Cysticercus  disease  is  rare  in  the  north,  centre,  and  east  of  France, 
and  in  districts  where  animals  are  reared  in  confinement.  It  is  commoner 
where  pigs  are  at  liberty,  such  as  Limousin,  Auvergne,  and  Perigord.  It 
is  frequent  in  North  Germany,  where  the  custom  of  eating  half-cooked 
meat  contributes  to  the  propagation  of  Tcenia  solium.  It  is  also  frequent 
it  Italy. 

BEEF    MEASLES. 

Causation.     The  disease  of  beef  measles  is  due  to  the  penetration 


m 


M^M-' 


j\i:^ 


Fig.  38. — Cysticercus  ccUnloscc  in  pork,     c.  Cysts;  v,  fibrous 
tissue  capsule  wbicli  forms  around  the  cyst. 


into  the  connective  and  muscular  tissues  of  embryos  of  the  Tcenia  scuji- 
nata,  or  unarmed  teenia  of  man. 

This  disease,  unlike  that  of  the  pig,  has  only  been  recognised 
within  comparatively  recent  times,  and  only  after  Weisse's  experiments 
(St.  Petersburg,  1841)  on  feeding  with  raw^  flesh  was  attention  drawn  to 
it,  although  as  early  as  1782  the  Tcenia  saginata  had  been  described  by 
Goeze. 

Measles  in  the  ox  is  rarely  seen  in  France,  but  is  common  in  North 
and  East  Africa.  Alix  has  found  it  in  Tunis,  Dupuys  and  Monod  in 
Senegal,  and  it  is  common  in  the  south  of  Algeria.     The  disease  is  due 


80 


DISEASES   OF   MUSCLES    AND   TENDONS, 


simply  to   oxen   swallowing  eggs  or  embryos   of  the  unarmed  tsenia,  a 
fact  which  explains  the  frequency  of  the  disease  in  places  where  the 


Fig.  39. — Anatomy  of  the  Cysticercus  celluloscB  (after  Robin).     A,  Cyst; 
B,  scolex  with  hooks  ;   C,  hooks  ;   D,  magnified  fragment  of  cyst. 

inhabitants  are  of  nomad  habits,  and  consequently  disregard  the  most 
elementary  rules  of  public  and  general  hygiene. 

Furthermore,  cattle  in  the  Sahara,  in  Senegal  and   in  the  Indies, 

have  a  very  marked  habit  of  eat- 
ing ordure,  and  as  no  attempts  are 
made  to  prevent  it,  the  risk  to  these 
animals  is  greatly  increased. 

As  in  the  pig,  the  embryos 
which  reach  the  stomach  and  intes- 
tine penetrate  into  the  circulatory 
system,  and  are  thereby  distributed 
throughout  the  entire  organism. 

The  development  of  the  cysti- 
cercus is  complete  in  forty  days, 
and  if  swallowed  by  man  in  infected 
meat  after  this  period  it  again  gives 
rise  to  the  Tcenia  saginata. 

The  age  of  the  animals  seems  of 

less   importance   than  in   the   case 
Fia.  40 -Section  of  a  beef  tongue  heavily      ^^  ^^^^      ■       ^^^,    ^^^  ^^^^^    ^^^^.^^ 

mfestecl  with  beet  measles,  natural  size  -^   '='  ■  ■,       n  i        • 

(Stiles,  Annual  Report  U.S.A.  Bureau     l^'^ve  seen  cases  ot  beef  measles  ni 
of  Agriculture,  1901).  animals  of  ten  years  old. 


BEEF   MEASLES. 


81 


Symptoms.       The 

symptoms  are  still  less 
marked  than  in  the  pig, 
and  in  ordinary  cases  of 
infection  always  escape 
observation.  Stiles,  how- 
ever, gives  the  following 
account  of  a  case  experi- 
mentally infected  : — 

"Symptoms.  Four 
days  after  feeding  seg- 
ments of  T.  saginata  to 
a  healthy  three-months- 
old  calf,  the  patient 
showed  a  higher  tem- 
perature (the  normal 
temperature  was  39'2" 
C).  The  calf  ate  but 
little  on  that  day,  showed 
an  accelerated  pulse, 
swollen  belly,  staring- 
coat,  and  upon  pressure 
on  the  sides  showed  signs 
of  pain.  The  next  day 
the  animal  was  more 
lively,  ate  a  little,  and 
for  nine  days  later  did 
not  show  any  special 
symptoms  except  pain 
on  pressure  of  the  abdo- 
minal walls,  and  a  slight 
fever.  Nine  days  after 
the  infection  the  tem- 
perature was  40"7°  C, 
pulse  86,  respiration  22  ; 
the  calf  laid  down  most 
of  the  time,  lost  its  ap- 
petite almost  entirely, 
and  groaned  consider- 
ably. When  driven  it 
showed  a  stiff  gait  and 
evident  pain  in  the  side. 
The       fever       increased 

D.C. 


82 


DISEASES    OF    MUSCLES    AND    TENDONS. 


gradually,  and  with  it  the  feebleness  and  low-spiritedness  of  the  calf, 
which  now  retained  a  recumbent  position  most  of  the  time,  being 
scarcely  able  to  rise  without  aid,  and  eating  only  mash  with  ground 
corn.  Diarrhoea  commenced,  the  temperature  fell  gradually,  and  on  the 
twenty-third  day  the  animal  died.  The  temperature  had  fallen  to 
38-2°  C.  During  the  last  few  days  the  calf  was  unable  to  rise ;  in  fact, 
it  could  scarcely  raise  its  head  to  lick  the  mash  placed  before  it.  Pulse 
was  reduced  by  ten  beats.  On  the  last  day  the  heart-beats  were  very 
much  slower,  yet  firm,  and  could  be  plainly  felt.     Several  days  before 

death  the  breathing  was  laboured,  and 
on  the  last  day  there  was  extreme 
dyspnrea." 

Diagnosis.  In  forming  a  diagnosis 
we  meet  with  the  same  difficulty  as  in 
the  case  of  the  pig.  It  is  always  easy 
to  examine  the  tongue ;  but  when 
visible  lesions  are  absent  diagnosis  in 
the  case  of  the  ox  remains  doubtful 
and  problematical  even  more  than  in 
the  pig. 

In  the  carcase,  diagnosis  is  much 
easier.  The  cysts  are  sought  for, 
as  in  the  pig,  by  making  sections  of 
muscle,  those  usually  selected  being 
the  pterygoid,  cervical,  cardiac,  and 
psoas  muscles,  and  those  of  the 
quarters. 

Prognosis.     The  prognosis  is  grave, 
not    indeed  for  the   infected  animals, 
which  seem  little  injured  by  the  para- 
site, but  for  human  beings,  who  run 
the  risk  of  contracting  Tcenia  iiwrmis 
V)y  eating  insufficiently-cooked  meat. 
A  temperature  of  115°  to  120°  Fahr.  destroys  the  cysticerci,  but  in 
roast  meats  the  central  temperature  of  the  mass  always  remains  below 
this  figure. 

Salting  for  fifteen  to  twenty  days  destroys  the  vitality  of  the  parasite. 
Lesions.     The  lesions  are  confined  to  the  presence  of  the  cyst  and 
of  two  little  zones  of  chronic  inflammation  immediately  surrounding  it. 
Unless  heavily  infested  the  subjects  fatten  just  as  well  as  others. 

The  vesicles  are  semi-ti-ansparent,  y\  inch  to  ^  inch  in  length,  slightly 
ovoid  in  form,  and  contain  a  taenia  head  with  four  suckers,  but  without 
hooks. 


Fig.  42.— Apex,  dorsal,  and  lateral 
views  of  the  head  of  beef-measle 
tapeworm  {Tcenia  saginata),  show- 
ing a  depression  in  the  centre  of  the 
apex.  X  17.  (Stiles,  Report  U.S.A. 
Bureau  of  Agriculture,  1901.) 


BEEF   MEASLES. 


83 


In  seven  to  eight  months  the  cysts  undergo  degeneration,  the  Hquid 
is  absorbed,  and  calcium  salts  are  deposited  throughout  the  mass.  The 
lesions  which  remain  have,  in  the  ox,  the  appearance  of  interstitial 
disseminated  tuberculosis. 

There  is  no  curative  treatment.  The  infested  animal  recovers  spon- 
taneously with  the  lapse  of  time,  for  the  cysticerci  undergo  degenerative 
processes,  but  the  flesh  of  such  animals  is  of  little  commercial  value. 

From  a  preventive  standpoint  we  can  only  hope  to  improve  matters  by 
a  gradual  and  progressive  change  in  social  and  public  hygienic  conditions. 

When  the  life  of  the  nomad  shall  have  been  entirely  replaced  by 
that  of  the  highly-civilised  European  and  private  hygienic  precautions 


Fig.  43. — Sexually  mature  segment  of  beef-measle  tapeworm  {Tcenia 
saginata).  c.x>.,  Cirrhus  pouch  with  cutIius  ;  d.c,  dorsal  canal; 
fjT.jj.,  genital  poi-e  ;  7i.,  lateral  longitudinal  nerves;  ov.,  ovary; 
s^/.,  shell-gland;  ^.,  testicles  ;  ?t^.,  median  uterine  stem,  enlarged  (in 
part  after  Leuckart)  ;  v.,  vagina ;  v.c,  ventral  canal,  connected  by 
transverse  canal  ;   tc,  vd.,  vas  deferens;  vg.,  vitellogene  gland. 


have  rendered  it  impossible  for  animals  to  obtain  access  to  segments  or 
eggs  of  the  Ttenia  saginata,  beef  measles  will  disappear. 

At  present,  in  the  countries  where  the  disease  is  common,  one 
experiences  a  feeling  of  astonishment  that  it  is  not  far  more  frequent; 
for  experiment  has  shown  that  a  person  infected  with  one  unarmed 
tapeworm  expels  with  the  fpeces  an  average  of  four  hundred  proglot- 
tides per  month,  each  proglottis  or  segment  of  the  worm  containing 
about  30,000  eggs,  each  of  which  is  capable  of  developing  into  a 
tapeworm. 

G  2 


84 


DISEASES    OF    MUSCLES    AND    TENDONS. 


Beef  measles  is  rather  common  in  Germany,  but  rare  in  France, 
Switzerland,  and  Italy. 

TRICHINIASIS-TRICHINOSIS. 

Trichinosis  is  a  disease  caused  hy  the  entrance  into  the  body  of  the 
Trichina  spiralis.  This  parasite  is  swallowed  in  the  larval  form,  and 
undergoes  sexual  changes  in  the  intestine,  at  first  producing  intestinal 
trichinosis,  which  represents  the  first  phase  in  the  development  of  the 
disease. 

The  trichinte  breed  rapidly.  The  embryos  penetrate  into  or  are 
directly  deposited  in  the  blood-vessels,  which  convey  them  to  all  parts  of 


Fig.  44. — Gravid  segmeut  of  beef- 
measle  tapeworm  [Tcenia  sagi- 
nata),  showing  lateral  branches 
of  the  uterus,  enlarged.  (Stiles, 
Annual  Report  U.S.A.  Bureau 
of  Agriculture,  1901.) 


Fig.  45. — Egg  of  beef-measle  tapeworm 
{Tcenia  saginata),  ^\•ith  thick  egg-shell 
(embrvophore"),  containing  the  six- 
hooked  embryo  (oncosphere),  enlarged. 
(After  Leuckart.) 


the  body,  thus  setting  up  the  second  phase  of  the  disease,  known  as 
muscular  trichinosis. 

Trichinosis  as  a  disease  has  long  been  recognised.  Peacock  in  1828 
and  J.  Hilton  in  1832  mentioned  the  existence  of  the  cysts  of  trichinae ; 
Owen  in  1H35  gave  the  name  of  Tridiina  spiralis  to  the  parasites  con- 
tained in  the  cysts.  Trichinosis  being  common  in  Germany  at  that  time, 
A'irchow  and  Leuckart  undertook  its  investigation,  but  mistook  other 
nematodes  of  the  intestine  for  the  Trichina  spiralis.  In  1847  Leydy 
recognised  that  trichinosis  occurred  in  American  pigs. 

In  1860  Zenker  found  muscular  and  intestinal  trichinosis  on  post- 
mortem examination  of  a  girl  who  had  been  suspected  of  suffering  from 
tyi)hoid  fever,  and  a  carefully  conducted  inquiry  revealed  the  fact  that 


TKICHINIASIS — TRICHINOSIS. 


85 


this  girl  had  some  time  previously  eaten  a  quantity  of  raw  ham.  Virchow 
and  Leuclcart  returned  to  their  investigations,  and  the  life  liistory  of  the 
parasite  soon  hecaine  definitely  known. 

Causation.  Trichinosis  is  capable  of  attacking  all  mammifers  with- 
out exception,  from  a  man  to  a  mouse ;  and  most  animals  which  can  be 
made  the  subjects  of  experiment  contract  the  disease  in  varying  degrees. 

The  intestinal  form  is  seen  in  l)irds,  but  the  muscles  do  not  become 
infested  by  the  embryos. 

Cold-blooded  animals  are  proof  against  the  disease. 

After  the  ingestion  of  meat  containing  cysts  of  the  parasite,  the 
processes  of  gastric  and  intestinal  digestion  set  the  larvse  at  liberty. 
These  larvae  become  sexual  at  the  end  of  four 
to  five  days,  and  the  females,  which  are  usually 
twice  as  numerous  as  the  males,  begin  laying 
eggs  from  the  sixth  day,  continuing  for  a 
month  to  six  weeks.  Each  female  lays 
approximately  from  10,000  to  15,000  eggs. 
The  embryos  perforate  the  intestinal  walls, 
pass  into  the  circulation,  and  are  hurried  into 
all  parts  of  the  system.  This  period  of  infes- 
tation constitutes  the  first  phase  of  the  disease. 

Askanazy,  in  1896,  suggested  that  it  was 
not  the  embryos  which  perforated  the  intes- 
tinal walls  and  thus  reached  the  blood-vessels, 
but  the  fertilised  female  trichinae  themselves, 
which  entered  the  terminal  chyle  vessels  and 
laid  their  eggs  directly  within  them. 

This  observation  is  of  great  interest,  for 
it  contradicts  the  view  held  by  Leuckart  and 
proves  that  treatment  is  useless  even  in  the 
first  phase. 

The  males  are  about  J^  inch  in  length,  the  females  J  inch  to  .jV  inch, 
and  are  ovo viviparous. 

Symptoms.  The  symptoms  lack  precise  character,  even  when  the 
disease  is  known  to  be  developing,  and  moreover  they  have  only  been 
carefully  observed  in  experimental  cases.  As  soon  as  the  laying  period 
begins,  signs  of  intestinal  disturbance  may  be  observed,  possibly  due  to 
embryos  perforating  the  intestinal  walls  (if  we  accept  Leuckart's  view),  or^ 
according  to  Askanazy,  to  adult  females  penetrating  the  chyle  vessels  and 
disturbing  intestinal  absorption. 

These  symptoms  are  only  appreciable  in  cases  of  "  massive  "  infesta- 
tion. If  shght,  the  disturliance  passes  unperceived.  In  severe  cases 
the  symptoms  consist  of  diarrhcea,  loss  of  appetite,  grinding  of  the  teeth, 


Fig.  46. — Male  trichina  from 
the  intestine.     (Colin.) 


86 


DISEASES    OF    MUSCLES    AND   TENDONS. 


abdominal  pain  in  the  t'orni  of  dull  colic,  and  sometimes  irritation  of  the 
peritoneum.  The  embryos  carried  by  the  circulation  then  escape  into 
the  tissues  and,  like  the  cysticerci,  become  encysted,  preferably  in  the 
muscles,  in  the  interfascicular  connective  tissue  towards  the  ends  of  the 
bundles.  Each  (asexual)  parasite  plays  the  part  of  a  foreign  body, 
causing  infiltration  of  serum  and  exudation  of  leucocytes  in  its  neighbour- 
hood, and  soon  l)ec()ming  encysted  in  the  interior  of  a  little  ovoid  space 
surrounded  by  a  libro-fatty  Avail.  Fat  granules  accumulate  at  each  end 
of  the  cyst. 

The' parasite,  which  at  iirst  appeared  straight,  soon  assumes  a  bent 
form,  then  that  of  a  figure  "  C),""  then  of  a  figure  "  B,"  and  preserves  a 


48. — Tnchiiiie  encys- 
ted in  the  nuisciilar 
tissue.     (Colin.) 


ri({.    49.— Old     (degene- 
rated)    trichina     cyst. 

(Colin.) 


latent  vitality  throughout  the  entire  period  of  encystment.  These  cysts 
are  of  very  small  dimensions,  invisible  to  the  naked  eye,  and  their 
disct)very  necessitates  the  use  of  the  microscope.  They  are  about  (j^^tli 
inch  in  length  and  j^„th  inch  in  width.  Very  frequently  two  or  three 
cysts  may  be  found  arranged  in  line,  presenting  the  appearance  of 
beads  on  a  string :  more  rarely  two  parasites  may  be  found  in  one  cyst ; 
exceptionally,  as  many  as  six  or  seven.  The  appearance  of  "  beads  on  a 
string  "  is  due  to  the  fact  that  the  parasites  follow  the  interfascicular 
capillaries. 

In  anim^vls  which  are  kept  for  a  long  time  and  fattened  the  cyst  walls 


TRICHINIASIS — TllICHINOSTS.  87 

undergo  fatty  infiltration.  The  change  is  commonest  in  pigs.  In  the 
same  way  calcareoui-'  infiltration  sometimes  occurs,  but  only  when  the 
parasites  have  lost  their  vitality.  This  calcareous  degeneration  consists 
in  the  deposit  of  carbonate  and  phosphate  of  lime  in  the  walls  of  the  cyst ; 
it  never  begins  before  the  seventh  or  eighth  month  after  infestation, 
and  is  sometimes  much  longer  delayed. 

No  man  or  animal  ever  becomes  infested  except  l)y  the  ingestion  of 
meat  or  drink  containing  larval  trichinfe.  The  pig  and  small  rodents 
are  most  frequently  attacked.  Man  contracts  trichinosis  by  eating  in- 
sufficiently cooked  infected  pork.  The  fact  that  small  rodents,  par- 
ticularly rats,  eat  the  bodies  of  their  kind  explains  the  persistence  of 
tricliinosis  in  certain  regions.  Pigs  roaming  at  large,  and  thus  liable 
to  find  and  eat  the  dead  bodies  of  such  rodents,  may  contract  trichinosis 
in  this  way  or  from  eating  ordure. 

For  some  weeks  after  the  larva;  have  penetrated  the  muscular  tissues 
the  animals  show  stiffness  of  the  limbs,  difficulty  in  moving,  and  in 
mastication,  etc.,  but  these  troubles  disappear  in  a  short  time. 

The  above  facts  explain  why  trichinosis  in  the  pig  is  almost  unknown 
in  France,  Italy,  and  Spain.  It  is  commoner  in  Germany  and  in  certain 
States  of  Europe,  such  as  Holland  and  Kussia,  although  investigations 
had  previously  shown  that  in  Paris  about  7  per  cent,  of  the  sewer  rats 
were  sufferers  from  trichinosis  and  that  in  Germany  the  percentage  rose 
as  high  as  15  to  20.  In  Chicago  and  Cincinnati,  U.S.A.,  the  proportion 
of  rats  suffering  from  trichinosis  has  been  as  high  as  50  to  70  per  cent., 
and  as  in  some  of  the  Northern  States  pigs  were  bred  in  complete 
freedom,  it  follows  that  at  one  time  very  large  numljers  of  American  pigs 
nuist  have  suffered  from  trichinosis. 

In  consecpience  of  sanitary  precautions  this  proportion  has  since 
greatly  diminished. 

Diagnosis.  ])uring  the  animal's  life  diagnosis  is  a  difficult  matter, 
though,  on  the  other  hand,  simple  microscopic  examination  of  suspected 
meat  is  sufficient  at  once  to  settle  the  question.  In  dealing  with  the 
living  animal,  however,  it  is  necessary,  as  in  examining  suspected  meat, 
to  obtain  a  fragment  of  muscle  in  order  to  submit  it  to  microscopic 
examination.  This  fragment  can  be  obtained  l)y  the  method  known  as 
"  harpoonage." — a  trocar  provided  with  a  cutting  hook,  or  a  trocar  the 
canula  of  which  has  a  sharp-edged  opening  near  its  end,  being  thrust 
into  the  muscle.  On  removing  the  trocar  the  elasticity  of  the  tissues 
causes  a  fragment  to  project  into  the  opening  in  the  canula,  and  on  with- 
drawing the  latter  a  fragment  sufficient  for  examination  is  obtained. 
One  may  proceed  in  the  same  way  by  harpoonage  when  examining  large 
masses  of  suspected  meat  the  surface  of  which  reveals  no  lesion. 

The    specimen    having    l)een    obtained,    a    few    fragments    of    the 


88  DISEASES   OF   MUSCLES   AND   TENDONS. 

muscular  fasciculi  are  crushed  between  t^YO  glasses  and  examined 
with  a  low  power. 

The  trichinae  will  be  found  towards  the  ends  of  the  muscle  near 
the  region  of  the  tendons ;  few  or  none  exist  in  the  fat.  These 
parasites  are  most  readily  discovered  in  the  diaphragm,  in  the 
muscles  of  the  shoulders  and  quarters,  and  in  the  psoas  muscles. 

Prognosis.  The  prognosis  is  relatively  favourable  so  long  as  infesta- 
tion is  only  moderate.  But  it  is  very  grave  from  the  point  of  view 
of  public  hygiene,  on  account  of  the  possibility  of  persons  becoming 
infected  by  eating  the  diseased  meat. 

Treatment.  There  is  no  'curative  treatment.  Formerly  it  was 
believed  that,  provided  the  condition  were  early  diagnosed,  the  intes- 
tinal form  might  possibly  be  cured  by  administering  purgatives  and 
vermifuges  so  as  to  prevent  the  embryos  penetrating  the  system. 

After  Askanazy's  discoveries  this  view  had  to  be  abandoned,  and 
the  practitioner  is  necessarily  powerless  in  dealing  with  the  muscular 
form.  Time  alone  effects  improvement  and  a  relative  cure  by  causing 
caseo-calcareous  degeneration  of  the  cysts.  ^Vith  a  prophylactic  object, 
every  precaution  should  be  taken  to  prevent  the  possibility  of  pigs  being 
contaminated.  This  question  particularly  interests  America,  because  of 
the  extreme  prevalency  of  pig  trichinosis  there. 

From  the  point  of  view  of  public  hygiene  all  infected  meat  should 
be  seized  and  destroyed,  despite  the  fact  that  perfect  cooking  destroys 
the  vitality  of  the  parasites,  which  perish  at  120°  Fahr. 

Ordinary  salting  but  slightly  affects  their  vitality,  which  explains 
why  from  time  to  time  the  importation  of  meat  has  to  l)e  prohibited 
and  why  meat  should  always  be  scrupulously  inspected. 


CHAPTER    V. 
RHEUMATISM, 

In  bovine  pathology  the  term  "  Eheumatism  "  is  appHed  to  a  number 
of  different  morbid  conditions,  the  sole  connection  between  which  is  that 
they  seriously  affect  the  organs  of  locomotion.  This  reason  may  perhaps 
l)e  accepted  as  sufficient  for  including  the  study  of  rheumatism  amongst 
diseases  affecting  locomotion. 

The  disease  is  of  considerable  importance,  and  for  this  reason  the 
study  of  rheumatism  itself  necessarily  precedes  the  description  of 
pseudo-rheumatism,  secondary  rheumatism,  or  infectious  rheumatism 
in  young  and  adult  animals. 

ARTICULAR  RHEUMATISM. 
Acute  rheumatism  has  a  clearly  marked  predilection  for  the  arti- 
culations. Sometimes  the  great  serous  meml)ranes  are  simultaneously 
affected  (pleura,  pericardium,  endocardium),  but  only  in  very  exceptional 
circumstances  are  they  primarily  attacked.  That  form  of  rheumatism 
known  as  visceral  is  as  a  general  rule  secondary  in  comparison  with 
articular  rheumatism.  Several  joints  and  tendon  sheaths  may  be 
attacked  at  the  same  time.  Under  such  circumstances  rheumatism 
may  be  defined  as  a  febrile  disease,  probably  of  an  infectious  nature, 
revealing  itself  by  simple  or  multiple  inflammation  of  joints  and  the 
tissues  surrounding  them,  and  capable  of  becoming  complicated  with 
inflammation  of  the  pleura,  pericardium,  endocardium,  meninges  of 
the  l)rain,  etc. 

Causation.  All  authors  agree  in  recognising  the  influence  of 
heredity,  of  wet  and  cold,  of  sudden  changes  in  temperature,  draughts 
in  the  stable,  prolonged  exposure  to  low  temperatures,  or  the  chilling 
of  animals  saturated  with  perspiration.  These  are  and  cannot  be  other- 
wise than  occasional  causes ;  l)ut  the  determining  cause  remains  at 
present  unknown. 

[  In  human  pathology  it  has  been  proved  beyond  dispute  that  a  certain 

relationship  exists  between  arthritism,  or  the  "  ui'ic  acid  diathesis,"  and 
rheumatism.     This  fact  is  so  well  recognised  that  doctors  have  said  that 

^        rheumatism  was  to  arthritism  what  scrofula  is  to  tuberculosis.     That, 

L 


90  RHEUMATISM. 

however,  does  not  advance  our  knowledge  of  the  question  in  the  smallest 
degree,  and  it  may  simply  be  that  arthritism  represents  one  of  the 
principal  favouring  conditions  in  the  development  of  rheumatism. 

In  domestic  animals  the  uric  acid  diathesis  is  little  known,  renal 
lithiasis  is  no  more  a  rarity  than  gravel ;  but  at  the  present  time  no 
one  appears  clearly  to  have  estal)lished  the  relationship  between  these 
diseases  and  the  development  of  rheumatism.  What,  however,  we  must 
all  admit  is  that  rheumatism  exhibits  all  the  phases  of  development  of 
a  rapidly  progressive  infectious  disease. 

Numerous  attempts  have  been  made  by  doctors  during  the  last  few 
years  to  discover  the  presence  of  a  microscopic  agent  and  to  demonstrate 
its  pathological  characteristics.  Several  microbes  have  been  described, 
but  one  is  forced  to  confess  that  the  results  have  until  now  been  very 
contradictory  and  uncertain  ;  and  yet  there  is  little  room  to  doubt  that 
the  disease  is  of  an  infectious  character. 

Symptoms.  The  symptoms  are  generally  well  defined  and  well 
developed.  The  onset  is  sudden ;  an  animal  which  one  day  before 
appeared  perfectly  well  is  attacked  in  one  or  several  joints.  Usually 
the  upper  joints  of  the  limb  are  involved — the  shoulder,  elbow,  knee, 
haunch,  stifle,  hock. 

Nevertheless,  invasion  is  probably  not  as  sudden  as  it  appears  to 
be,  and,  as  in  the  human  species,  the  subject  begins  by  feeling  erratic 
pains,  which,  however,  pass  unnoticed.  The  animal  moves  with  diffi- 
culty, as  though  it  were  suffering  from  laminitis,  and  has  pain  when 
placing  weight  on  the  limb,  while  the  joint  attacked  soon  shows  a 
swelling  which  extends  to  the  tendon  sheaths  and  the  neighbouring 
serous  bursae.  The  local  temperature  is  higher  than  that  of  sur- 
rounding parts,  sensibility  becomes  very  marked,  and  pain  attends 
the  slightest  pressure  on,  or  even  movement  of,  the  affected  joint. 
Intense  lameness  follows,  which  may  even  at  first  give  rise  to  the 
suspicion  of  fracture.  The  animals  remain  lying  for  long  periods, 
groan  from  time  to  time,  and  suffer  great  pain  when  rising. 

In  some  cases  the  local  manifestations  appear  to  be  transferred 
from  one  joint  to  another. 

These  local  symptoms  are  accompanied  by  high  fever.  The 
temperature  rises  to  105°  or  106°  Fahr.,  the  pulse  to  80  or  90,  and 
the  breathing  is  enormously  accelerated  if  the  patients  are  forced 
to  move. 

Loss  of  appetite  is  very  marked.  Eumination  may  be  suspended, 
and  these  grave  symptoms  are  accompanied  by  constipation,  rapid 
wasting,  cessation  or  marked  diminution  of  the  milk  supply,  decrease 
in  the  quantity  of  urine  passed,  etc. 

A  few  days  after  the  onset,  visceral  complications  may  occur,  though 


ARTICULAR   RHEUMATISM.  91 

fortimafcely  such  complications  are  far  from  being  constant.  Auscultation 
and  percussion  sometimes  reveal  the  lesions  of  pleuris}^  endocarditis, 
pericarditis,  etc. 

The  development  of  articular  rheumatism  varies  greatly,  and  may 
occasionally  continue  for  ^Yeeks  or  months,  the  condition  of  one  joint 
improving  only  to  be  followed  by  inflammation  of  another. 

The  visceral  lesions  rarely  disappear  completely',  and  it  is  not  un- 
common to  note  sj'mptoms  of  chronic  valvular  endocarditis.  Eelapses 
are  somewhat  frequent,  and  the  disease  may  continue  in  a  chronic  form 
after  the  acute  symptoms  have  disappeared. 

Lesions.  The  joint  itself  is  not  alone  affected.  All  the  tissues  sur- 
rounding it  are  congested,  swollen  and  painful,  particularly  the  sheaths 
and  insertions  of  the  tendons.  Within  the  inflamed  synovial  capsules 
of  the  joints  an  increased  quantity  of  turbid  synovia  accumulates,  dis- 
tending the  joint  and  producing  a  condition  of  hydrarthrosis. 

In  animals  slaughtered  during  the  course  of  the  disease  one  finds 
congestive  infiltration  of  the  limbs. 

The  temperature  of  the  parts  near  the  affected  joints  is  higher  than 
that  of  neighbouring  regions.  Sensibility  is  much  more  acute,  and  the 
slightest  external  pressure  gives  rise  to  pain. 

In  favourable  cases  the  joint  may  appear  scarcely  injured.  The 
principal  symptoms  are  those  of  pain.  In  old-standing  cases  certain 
l^ermanent  changes  may  occur,  such  as  thickening  and  hardening  of  the 
wall  of  the  synovial  capsule,  fibrous  infiltration  of  the  tissues  around  the 
joint,  or  even  diffuse  and  irregular  calcareous  infiltration. 

Cases  of  false  or  true  anchylosis  are  rare,  the  animals  usually  being 
slaughtered  before  such  conditions  can  develop. 

Complications.  The  commonest  complications  are  endocarditis  and 
pericarditis.  Valvular  endocarditis  localised  in  the  auriculo-ventricular 
valves  is  revealed  by  a  systolic  sound,  and  by  tumultuous  or  irregular 
beating  of  the  heart  when  the  animals  are  forced  to  move.  Pericarditis, 
which  seems  rare  in  bovine  animals,  is  much  commoner  in  sheep.  This 
pericarditis,  however,  produces  none  of  the  external  signs  of  pericarditis 
due  to  a  foreign  body.  Like  tuberculous  pericarditis,  it  is  only  accom- 
panied by  a  trifling  amount  of  exudate,  and  is  recognised  by  increased 
cardiac  dulness  and  diminution  in  the  cardiac  sounds  on  auscultation. 

Simple  pleurisy  associated  with  pericarditis  is  frequent  in  sheep,  but 
unknown  or  little  known  in  the  ox. 

If  in  animals  other  visceral  complications  occur,  affecting  the  peri- 
toneum, meninges  of  the  ])rain  or  intestines,  they  are  at  present  little 
recognised. 

Diagnosis.  Articular  rheumatism  can  only  be  confused  with  osseous 
cachexia  or  laminitis.     Osseous  cachexia,  however,  possesses  symptoms 


92  RHEUiMATISM. 

peculiar  to  itself,  and  generally  extends  to  an  entire  district,  whilst 
rheumatism  appears  in  an  isolated  form.  Again,  the  arthritis  peculiar 
to  osseous  cachexia  most  commonly  affects  the  joints  of  the  extremities 
(fetlock  and  phalanges).  The  disease  may  be  differentiated  from  laminitis 
by  simply  manipulating  the  joints,  which  are  painful  in  rheumatism 
but  not  in  laminitis,  and  by  percussing  the  claws,  which  are  painful  in 
laminitis  but  not  in  rheumatism,  and  by  noting  the  character  of  the  gait. 

Prognosis.  The  prognosis  is  grave,  as  in  all  acute  diseases  which 
are  capable  of  assuming  a  protracted  chronic  form.  It  is  also  necessary 
to  take  into  account  the  loss  of  condition,  the  possibility  of  relapse,  and 
the  complications  due  to  prolonged  decubitus. 

Treatment.  The  first  indication  is  to  place  the  patients  in  a  nearly 
constant  temperature,  to  supply  bedding  generously,  and  to  arrange  for 
the  animal  being  undisturbed.  Among  drugs  salicylate  of  soda  gives  the 
best  results  if  administered  in  sufficient  doses — 6  to  7  drams  per  day  for 
oxen  or  cows  of  medium  size,  45  to  75  grains  for  sheep. 

Diuretics,  like  bicarbonate  of  soda,  nitrate  of  potash  and  hay  tea  or 
infusion  of  couch  grass,  pellitory,  etc.,  also  give  good  results. 

The  joints  attacked  may  be  blistered,  but  it  is  often  preferable  to  use 
mild  ointments,  containing  camphor  or  belladonna,  because,  as  soon  as 
pain  diminishes,  moderate  massage  of  the  affected  parts,  which  favours 
rapid  absorption  of  the  effiisions,  can  then  at  once  be  resorted  to.  The 
diet  should  consist  of  easily  digested  food  and  of  lukewarm  hay  tea,  etc. 
When  the  animals  are  suffering  from  kidney  disease  in  any  form 
salicylate  of  soda  is  contra-indicated. 

Antipyrin  may  also  be  of  service  in  doses  of  45  to  75  grains  for  bo  vines 
and  15  grains  for  sheep.  Preparations  of  methyl  salicylate  can  only  be 
used  for  animals  of  value. 


MUSCULAR    RHEUMATISM. 

Muscular  rheumatism  is  due  to  causes  similar  to  those  of  articular 
rheumatism.  The  symptoms,  moreover,  often  occur  simultaneously,  or 
may  alternate  with  the  articular  manifestations,  with  which  they  are 
seldom  entirely  unconnected. 

Moist  cold  seems  to  be  the  predetermining  cause,  whether  it  acts 
indirectly  on  the  nerve  trunks  or  affects  the  capillar}^  circulation  in  the 
muscles,  through  the  medium  of  the  vaso-motor  supply.  The  results  are 
revealed  by  the  development  of  neuralgia,  neuritis  or  interstitial  myositis; 
and  these  diseases,  by  producing  more  or  less  intense  pain,  cause 
difficulty  in  movement  or  distinct  lameness.  Attempts  have  been  made 
to  explain  the  development  of  these  lesions  by  ascribing  a  certain  action 
to  the  uric  acid  (which  is  said  to  be  in  excess  in  the  body),  and  to  the 


MUSCULAR   RHEUMATISM.  93 

lactic  acid,  which  accumulates  in  the  muscular  tissue  after  fatigue  or 
over-exertion,  and  may  occasionally  produce  temporary  myositis.  Up  to 
the  present  time,  no  satisfactory  proof  has  heen  furnished  enabling  us 
to  identify  the  myositis  of  rheumatism  with  the  myositis  of  over-exertion, 
which,  moreover,  appears  to  differ  from  it  in  essential  particulars. 

Symptoms.  Muscular  rheumatism  is  often  ill-recognised  in  veterinary 
medicine,  and  closer  observation  would  appear  to  suggest  that  it  is 
much  less  frequent  than  has  been  stated.  Generalised  muscular  rheu- 
matism is  rare;  patients  stand  stiffly  as  though  incapable  of  moving; 
the  limbs  and  the  back  appear  rigid,  and  the  animal  seems  only  capable 
of  changing  its  position  by  a  single  movement  of  its  whole  body.  One 
might  readily  believe  at  first  sight  that  the  case  was  one  of  generalised 
laminitis  or  slight  generalised  tetanus.  The  animal  has  difficulty  in 
rising ;  when  moving  the  limbs  are  dragged,  and  the  patient  is  cautious 
in  lying  down. 

Most  frequently  the  disease  is  localised  in  one  region,  such  as  the 
shoulder,  the  loins,  or  the  quarters.  The  affected  part  is  stiff,  tense, 
painful,  hard,  and  as  though  in  a  state  of  cramp.  Palpation  and  pressure 
reveal  the  presence  of  very  exaggerated  sensibility,  which  varies  within 
wide  limits,  according  to  circumstances,  changes  in  atmospheric  con- 
ditions, etc.  These  local  signs  are  accompanied  by  a  general  reaction  of 
varying  severity,  somewhat  resembling  that  seen  in  articular  rheumatism. 
Appetite  is  diminished  or  suppressed,  as  is  rumination  ;  the  muzzle  is  dry 
and  hot ;  the  temperature  may  rise  as  high  as  103°  or  104°  Fahr. 

Lesions.  The  lesions  are  imperfectly  recognised,  because  those  who 
might  most  easily  observe  and  study  them  have  often  neither  the  means 
nor  the  leisure  for  the  purpose.  Possibly  one  would  at  times  discover 
lesions  of  neuritis  ;  but  in  any  case  it  is  not  so  very  rare  to  discover 
lesions  of  interstitial  sclerosing  myositis  in  the  depths  of  the  muscles  of 
the  quarter,  loins,  shoulders,  etc.,  a  condition  rarely  found  in  any  other 
disease.  Naturally  these  are  only  the  ultimate  lesions  of  muscular 
rheumatism ;  for  slight  attacks  leave  no  traces  visible  to  external 
examination. 

Diagnosis.  The  commonest  error  is  that  of  mistaking  the  condition 
for  laminitis  of  all  four  limbs.  The  history  often  suffices  to  eliminate 
this  disease  from  consideration,  while  palpation  and  percussion  of  the 
claws  remove  any  remaining  doubt. 

The  prognosis  is  not  usually  grave,  and  recovery  sometimes  follows 
the  adoption  of  good  hygienic  conditions.  On  the  other  hand,  certain 
patients  lose  flesh  rapidly. 

Treatment.  Salicylate  of  soda  and  antipyrin  still  form  the  two  most 
efficacious  drugs,  particularly  the  first,  which  may  almost  be  regarded  as 
a  veritable  specific  in  rheumatism.     The  doses  vary  with  the  size  of  the 


94  RHEUMATISM. 

patients,  from  2^  to  7  drams  per  da3^  These  doses  are  continued  for  six 
to  eight  days  consecutively.  Some  authors  prefer  saUcylic  acid,  which, 
however,  is  more  irritant,  in  doses  of  15  to  75  grains.  Tartar  emetic,  in 
doses  of  2  J  to  4  drams  per  day  until  purgation  is  established,  is  also  said 
to  have  proved  of  great  value  in  the  hands  of  the  older  practitioners. 
Local  treatment  comprises  stimulating  frictions  with  camphorated  alcohol, 
ammonia,  and  oil  of  turpentine.  Such  applications  are  usually  of  great 
service,  particularly  when  associated  with  methodical  massage  of  the 
affected  parts.  These  modes  of  treatment  should  be  supplemented  with 
a  proper  dietary  and  the  administration  of  tepid,  diuretic  fluids  as 
required. 

Infectious  Forms  of  Eheumatism  or  Pseudo-Eheumatism. 

Under  the  head  of  infectious  rheumatism  or  pseudo-rheumatism  may 
be  grouped  joint  diseases  of  a  rheumatic  type  accompanjnng  various 
general  or  local  diseases  in  young  animals  and  adults  :  diseases  of  the 
umbilicus,  rachitis,  peri-pneumonia,  retention  of  the  foetus,  dysentery, 
etc.  These  diseases  are  characterised  by  articular  symptoms,  which 
sometimes  appear  early,  sometimes  only  when  the  disease  itself  is 
declining,  and  develop  suddenly  or  gradually,  the  joint  cavities  them- 
selves either  being  directly  invaded  by  the  agents  of  the  primary  disease 
or  remaining  exempt.  These  pseudo-rheumatic  attacks  are  due  to  the 
localised  action  of  microbic  toxins  on  the  articular  synovial  membranes. 
Sometimes  the  serous  membranes  of  the  large  body  cavities  are  also 
implicated. 

This  theory  explains  the  development  of  acute  arthritis  without  the 
presence  of  gonococci  during  the  course  of  an  attack  of  blenorrhagia  in 
man,  and  may  be  applied  in  respect  of  certain  forms  of  arthritis  or 
synovitis  without  the  presence  of  microbes  in  domestic  animals. 

INFECTIOUS    RHEUMATISM    IN    YOUNG    ANIMALS. 

Causation.  To  explain  the  occurrence  of  infectious  rheumatism  in 
young  animals  a  variety  of  causes  has  been  invoked,  such  as  bad  feeding, 
the  absence  of  that  purgation  which  usually  follows  the  action  of  the 
mother's  first  milk  {i.e.,  colostrum),  and  clears  the  bowel  of  meconium, 
the  effect  of  heredity,  of  chills,,  of  insuftieient  food,  and  of  unduly  abun- 
dant or  very  rich  food,  which  has  been  said  to  produce  indigestion  and 
its  various  complications. 

All  these  causes  may  play  a  certain  part  in  favouring  the  develop- 
ment of  infectious  rheumatism,  but  none  constitutes  the  direct  cause. 

Lecoq  and  Loiset  in   their  investigations  regarding   this  disease  in 


INFECTIOUS    RHEUMATISM    IN    YOUNG    ANIMALS.  95 

colfcs  mentioned  the  almost  invariable  existence  of  lesions  in  the  umbilical 
region.  Bolinger  in  1869  recognised  the  possil)ility  of  infection  by  way 
of  the  mnbilical  vein.  Eoll  and  Guillebeau  are  of  the  same  opinion,  and 
Morot's  excellent  study  shows  that  here  must  be  sought  the  most  fre- 
quent point  of  origin  of  the  articular  symptoms.  In  animals  born  in  dirty 
stables  the  umbilical  cord  becomes  infected  at  the  time  of  birth,  or  its 
cicatrix  a  few  days  later.  The  result  is  the  development  of  rapidly  fatal 
septicaemia,  suppuration  in  the  wound,  omphalitis,  omphalo-phlebitis,  or 
umbilical  arteritis  ;  and  to  this  infection  are  due  the  various  complications, 
which  may.  appear  almost  immediately,  as  in  the  case  of  septic^nemia  of 
calves,  or  may  be  deferred  for  a  shorter  or  longer  interval,  for  so  long  indeed 
that  the  umbilicus  may  appear  to  have  healed  externally  (infectious  pneu- 
monia and  endocarditis,  infectious  arthritis,  etc.).  The  umbilical  cord 
and  the  tissues  surrounding  the  cicatrix  form  excellent  culture  grounds 
for  those  micro-organisms  which  always  exist  in  such  abundance  in  litter 
and  manure  ;  and  there  is,  therefore,  no  difficulty  in  understanding  why  in 
dirty  stables  infection  so  readily  occurs.  The  infective  agents  may  be  of 
very  varying  kinds,  a  fact  which  explains  the  difference  in  the  symptoms 
which  follow  umbilical  infection  ;  although  ovoid  bacteria,  streptococcus 
pyogenes,  and  the  bacilli  of  necrosis  seem  most  common. 

Omphalitis  and  omphalo-phlebitis  are  not  the  only  diseases  capable 
of  producing  infectious  rheumatism  in  young  animals.  Certain  infections 
resembling  dysentery  and  diarrhoeic  enteritis  are  also  its  frequent 
forerunners.  In  3'oung  animals  even  rachitis,  which  is  accompanied 
by  various  digestive  disorders,  may  serve  as  the  point  of  origin  for 
infectious  rheumatism  and  all  its  complications. 

In  older  animals — i.e.,  in  animals  from  five  to  six  months,  or  even  twelve 
to  fifteen  months — infectious  rheumatism  may  occur  without  a  clearly 
defined  cause.  It  then  develops  with  the  symptoms  and  lesions  of  that 
condition  known  as  "  osteomyelitis  of  adolescence"  in  human  pathology. 
These  forms  of  osteomj-elitis  are  due  to  infection  with  streptococci 
and  staphylococci.  In  veterinary  medicine  the  pathogeny  has  not  yet 
been  accurately  ascertained. 

Symptoms.  Infectious  rheumatism  in  young  animals  assumes  one 
of  two  clinical  appearances,  possibly  due  to  different  causes,  viz. — plastic 
or  suppurative  arthritis  following  umbilical  infection,  and  simple 
exudative  arthritis.  In  the  former  variety  symptoms  appear  soon  after 
birth,  rarely  after  the  age  of  two  months,  and  as  an  exception  in  animals 
of  six  to  eight  months  affected  with  rachitis.  The  onset  is  sometimes 
sudden;  the  patient,  though  healthy  on  the  previous  evening,  is  un- 
able next  morning  to  rise  or  move.  Hence  in  France  this  disease  has 
received  the  titles,  amongst  others,  of  laminitis  and  paralysis  of  the 
Bewly  born. 


96 


RHEUMATLSM. 


Certain  joints,  often  a  pair,  appear  swollen,  hot  and  painful.  The 
synovial  sacs  are  distended,  and  in  the  upper  joints  of  the  limb  appear 
much  more  prominent  than  in  the  lower.     When  the  patients  are  still 


Fig.  50. — Young  bull  suffering  from  infectious  rheumatism. 

able  to  move  they  walk  on  three  legs,  but  usually  they  remain  lying 
permanently,  and  if  aroused  show  great  difficulty  in  rising  and  very 
acute  pain  in  moving. 

General  disturl)ance  is  also  very  marked;  the  temperature  varies 
between  103°  and  105°  Fahr.     The  animals  are  dull,  have  no  appetite,  and 

exhibit  intense  thirst.  The 
pulse  rate  and  respirations 
are  increased,  and  not  un- 
commonly symptoms  of  grave 
visceral  complications,  such 
as  endocarditis,  pleurisy, 
pneumonia,  etc.,  can  be  de- 
tected. Diarrhoeic  enteritis 
sometimes  appears  as  a 
secondary  development. 

The  animals  remain  per- 
manently lying  down.  They 
can  only  be  induced  to  rise 
with  difficulty,  and,  when 
moved,  exhibit  very  acute 
pain. 

In  many  cases  the  disease  then  takes  a  rapid  course  and  ends 
fatally.  Death  is  the  usual  termination  whenever  any  of  the  above- 
mentioned  visceral  complications    exist.     Recovery  is    exceptional.     In 


Fig.    51. — Attitude    when    walking    of    a 
suffering  from  infectious  rlieumatism. 


calf 


INFECTIOUS   RHEUMATISM   IN   YOUNG   ANIMALS.  97 

certain  Incky  cases,  sometimes  without  any  treatment  whatever,  the 
symptoms  become  less  acute,  the  appetite  persists  or  improves,  fever 
diminishes,  the  condition  of  the  joints  remains  stationary,  and  after  the 
hipse  of  several  weeks  there  is  ground  for  anticipating  recovery.  In  all 
cases,  however,  the  convalescents  remain  thin  and  sickly,  exhibit  pain 
and  capricious  appetite,  and  in  very  few  cases  indeed  is  there  any  economic 
reason  for  keeping  them  alive. 

More  frequently  infectious  rheumatism  terminates  by  abscess  forma- 
tion in  the  joints.  The  articular  cavity  becomes  filled  with  pus,  the 
tissues  covering  one  of  the  synovial  sacs  soften,  and  the  abscess  opens, 
discharging  fibrinous  clots,  thin  watery  pus  mixed  with  synovia, 
and  debris  of  articular  cartilages  or  ligaments.  Pytemia  is  the  final 
complication  when  the  patients  are  not  slaughtered. 

In  the  cases  comprised  under  the  second  heading  the  symptoms 
appear  more  slowly  and  develop  insidiously,  the  chief,  viz.,  a  tendency 
to  remain  lying  and  difficulty  in  movement,  long  preceding  the  appear- 
ance of  exudative  arthritis.  The  course  depends  chiefly  on  the  nature 
of  the  infective  agent.  In  calves  suffering  from  peripneumonia,  calves 
from  stables  in  which  epizootic  abortion  rages,  rachitic  calves  or  calves 
suffering  from  severe  diarrhoeic  enteritis,  the  joints  do  not  become 
the  seat  of  suppuration. 

In  such  cases  the  arthritis  is  of  a  simple  exudative  character,  but 
without  microbic  infection  of  the  joint  cavity.  This  form  is  less 
dangerous,  and  is  often  curable  provided  the  original  cause  be  kept 
in  mind. 

Lesions.  The  lesions  are  always  very  marked,  and  are  quite 
different  from  those  of  simple  rheumatism.  The  synovial  membranes 
and  the  periarticular  tissues  are  always  thickened,  injected,  inflamed, 
and  infiltrated. 

In  more  benign  cases  the  synovial  exudate  from  the  joint  cavities 
is  simply  cloudy,  contains  no  infectious  germs,  and  proves  sterile  on 
attempts  at  cultivation.  In  such  cases  there  is  no  abscess  formation. 
But  most  frequently  this  stage  of  serous  exudation  is  only  temporary, 
and  the  articular  fluid,  which  at  first  seems  sterile,  may,  when  tested 
some  days  later  by  means  of  cultures,  reveal  the  presence  of  organisms. 
The  synovia  accumulated  within  the  joint  sometimes  contains  fibrinous 
flocculi,  which  are  at  first  small,  but  later  form  veritable  coagula,  filling 
up  and  thickly  coating  all  the  prominences  of  the  joint  and  moulding 
themselves  on  the  extremities  of  the  bones  constituting  the  articulation. 
Sometimes  the  cartilages  undergo  very  rapid  ulceration,  the  subjacent 
layers  of  bone  become  inflamed,  and  the  osteoarthritis  which  develops 
is  so  severe  and  painful  that  the  patients  are  forced  to  remain  abso- 
lutely still,  and  are  quite  incapable  of  rising.  The  lesions  may 
D.C.  H 


98  RHEUMATISM. 

remain  stationary  at  this  point.  In  other  cases  suppuration  occurs  in 
the  articulation  itself,  the  wall  of  the  synovial  cavity,  the  periarticular 
tissues,  and  the  skin  soften ;  then  the  ahscess  breaks,  giving  rise  to  open 
suppurating  arthritis.  Animals  are  rarely  kept  long  enough  to  become 
so  gravely  affected ;  many  die  before  this  stage,  and  the  others  are 
usually  slaughtered.  Moreover,  they  rapidly  perish  from  exhaustion 
and  from  visceral  complications  of  a  pyfemic  character. 

In  many  cases  post-mortem  examination  reveals  nothing  whatever  in 
the  region  of  the  umbilical  cord  (through  which  infection  has  occurred), 
but  the  germs  of  infection  may  be  found  in  the  blood  or  general 
circulation  ;  or  again,  careful  investigation  may  show  ulceration  of  the 
umbilicus,    lesions    of    omphalitis,    of    ascending    umbilical    arteritis    in 


Fig.  52. — Ulcer;ition   ot   the  articnlav  cartilage  in  infections  rlienniatism. 

consequence  of  infection  of  the  thrombus,  of  umbilical  phlebitis,  or  of 
infective  peritonitis,  etc.  The  infectious  agent  reaches  the  liver  through 
the  l)lood-vessels,  then  attains  the  posterior  vena  cava,  after  which  the 
infection  assumes  the  gravest  possible  character,  producing  complications 
like  arthritis  and  purulent  infection,  with  the  formation  of  multiple 
abscesses  in  the  depths  of  the  viscera. 

The  Staphylococcus  aureus  and  various  streptococci  are  the  most 
frequent  but  not  the  only  causes  of  these  infections. 

The  diagnosis  is  not  difficult,  provided  the  disease  be  not  mistaken 
for  true  rheumatism.  As  true  rheumatism  is  very  rare  in  young  animals, 
and  as,  on  the  other  hand,  attention  is  aroused  by  the  presence  of 
lesions  of  the  umbilicus  and  by  the  ex-istence  of  diarrhceic  enteritis, 
rachitis,  etc.,  there  is  seldom  room  for  doubt. 

Prognosis.     The  prognosis  is   extremely  grave  whenever   the  case 


INFECTIOUS   PSEUDO-RHEUMATISM   IN    ADULTS.  99 

results  fi-om  infection  of  the  umbilicus.  French  statistics  place  the 
mortality  at  90  per  cent,  and  German  at  75  per  cent. 

Curative  treatment  can  only  be  attempted  with  any  chance  of  success 
in  the  simple  exudative  form.  Even  then  it  is  necessary  to  simultaneously 
treat  the  primary  disease,  such  as  rachitis  or  diarrhoeic  enteritis. 

The  recommendations  of  former  practitioners  as  to  the  use  of  saline 
purgatives,  cream  of  tartar,  etc.,  were  probably  due  to  their  having  recog- 
nised that  diarrhoea  is  sometimes  the  primary  cause. 

Moussu  has  seen  simple  exudative  arthritis  in  rachitic  subjects 
disappear,  together  with  the  rachitis,  under  proper  treatment. 

The  indications  therefore  are,  firstly,  to  take  measures  against  the 
primary  disease,  treating  the  local  lesions  separately  with  blisters,  douches, 
or  simply  cold  applications  and  massage.  Provided  the  general  condition 
can  be  improved,  recovery  may  follow. 

Unfortunately,  this  treatment  is  useless  against  infectious  rheumatism 
with  suppurative  arthritis  resulting  from  infection  of  the  umbihcus.  In 
such  cases  treatment,  if  undertaken,  should  be  directed  towards  perfectly 
disinfecting  the  umbihcal  wound  or  any  existing  sinuses. 

Injections  of  strong  carbolic  solution,  the  application  of  antiseptic 
ointments  or  of  antiseptic  pencils  containing  iodoform,  salol,  etc.,  into  the 
sinuses,  followed  by  a  surgical  dressing  covering  the  umbilicus,  form  the 
basis  of  this  primary  treatment,  which,  it  need  scarcely  be  said,  has  little 
chance  of  checking  the  course  of  already  existing  arthritis.  The  use  of 
internal  antiseptics  and  of  antipyretics  like  camphor,  salicylate  of  soda, 
etc.,  is  worthy  of  trial.  On  the  other  hand,  prophylactic  treatment  in  an 
infected  area  has  every  chance  of  succeeding.  The  use  of  dry,  clean 
litter  under  the  mother  and  the  new-born  calf,  thorough  cleansing  of 
the  umbilical  cord  or  umbilical  cicatrix,  and  the  application  to  the 
umbilicus  of  a  small  surgical  dressing  or  even  a  smear  of  tar,  almost 
always  suffice  to  prevent  the  occurrence  of  these  forms  of  arthritis. 

INFECTIOUS    PSEUDO-RHEUMATISM    IN    ADULTS. 

The  infectious  pseudo-rheumatism  of  adults  differs  from  infectious 
rheumatism  in  young  animals  in  that  it  never  becomes  complicated 
with  suppurative  arthritis,  and  rarely  affects  more  than  one  joint  at 
a  time.  The  hind  limbs  are  the  parts  usually  attacked,  and  the  joints 
seem  predisposed  to  disease  in  the  following  order  of  frequency :  the 
femoro-tibial,  coxo-femoral,  and  hock  joints. 

On  account  of  its  greater  frequency  in  cows,  it  has  been  termed 
"arthritis  of  milch  cows"  and  "infectious  arthritis  of  milch  cows,"  etc. 
In  reality  it  may  also  attack  bulls  and  oxen,  but  such  cases  are 
exceptional. 

H  2 


100 


EHEUMATISM. 


Causation.  First  mentioned  l)y  Coulbeaux  in  1824,  and  by  Pauleau 
in  1832,  this  disease  has  been  well-studied  by  Ph.  Hen.  Old  works 
mention  it  as  attacking  good  milkers  in  the  best  dairies  around  Paris, 
and  Heu  declares  it  to  be  the  most  deadly  disease  after  peripneumonia 
and  tuberculosis. 

This  form  of  arthritis  usually  appears  in  an  insidious  form  after 
abortion,  retention  of  the  foetus,  or  post-partum  metritis.  In  cases  of 
epizootic  abortion  infectious  rheumatism  sometimes  assumes  an  epizootic 
form,  and  completes  the  devastation  begun  by  abortion.  Under  other  and 
much  rarer  circumstances  it  may  follow  enteritis  of  adults  or  attacks 
of  mammitis,  etc.      The  pathogeny  of  these  forms  of  arthritis  is  not 


Fig.  53. — Infectious  rheumatism.     Arthritis  of  the  left  stifle  joint. 


difficult  to  understand,  for  in  the  greater  number  of  instances  they  form 
delayed  consequences  of  local  uterine  infection. 

The  soluble  products  secreted  by  infectious  organisms  multiplying 
within  the  uterus  are  absorbed  by  the  uterine  mucous  membrane,  causing 
slow  intoxication  ;  and  in  consequence  of  the  special  elective  aflfinity 
which  the  toxins  show  for  the  articular  serous  membranes,  and  in  many 
cases  also  for  the  visceral  serous  membranes,  the  special  characteristics 
are  developed.  Under  certain  circumstances  the  joint  cavity  may  even 
become  the  seat  of  true  microbic  infection. 

Symptoms.  The  appearance  of  the  first  symptoms  is  difficult  to 
identify,  for  many  cows  abort,  fail  to  "  cleanse,"  or  become  affected  with 
metritis  without  infectious  rheumatism  supervening.  It  is  a  long-delayed 
condition,  which  may  be  postponed  for  weeks  or  even  for  several  months 
after  an  abnormal  parturition,  and  to  a  time  when  the  symptoms  of 
metritis  have  almost  entirely  disappeared.     The  onset  is  characterised 


INFECTIOUS   PSEUDO-RHEUMATISM   IN   ADULTS. 


101 


by  difficulty  in  rising,  and  soon  afterwards  by  lameness,  or  by  the  animal 
failing  to  place  weight  on  one  of  the  hind  limbs.  The  affected  joint, 
usually  one  of  the  articulations  of  the  stifle,  appears  markedly  enlarged, 
is  not  appreciably  hot  to  the  touch,  but  reveals  a  certain  amount  of 


Fig.  54. — The  femoro-tibial  joint  in  a  case  of 
infectious  rheumatism.  All  the  articular  sur- 
faces of  one  side  have  undergone  change  (the 
condyle  of  the  femur,  interarticular  cartilage, 
and  the  upper  extremity  of  the  femur). 


FiCx.  55. ~ 
joint. 


Normal  femoro-tibial 


painful  sensibility  on  pressure.  The  periarticular  tissues  are  infiltrated 
and  the  synovial  sacs  slightly  distended. 

After  a  few  days,  a  week  or  two  at  most,  the  periarticular  swelling 
diminishes,  and  the  condition  appears  to  remain  stationary. 

Appetite  is  normal  or  only  diminished.  The  pain  continues,  and 
causes  progressive  wasting  and  diminution  in  the  yield  of  milk. 

If  at  this  time  the  practitioner  makes  a  careful  digital  examination  of 
the  diseased  region,  he  may  find  one  of  two  conditions.     In  the  first,  the 


102 


RHEUMATISM. 


synovial  sacs  appear  distended,  fluctuating  and  in  exactly  the  same 
condition  as  in  ordinary  bog-spavin.  This  is  what  has  been  termed  the 
exudative  form  of  infectious  arthritis.  In  the  second,  the  enlarged  joint 
remains  very  sensitive,  the  walls  of  the  synovial  sac  are  thickened, 
fluctuation  is  either  absent  or  only  slightly  marked,  but  induration  is 
very  manifest.     This  constitutes  the  plastic  form. 

Exudative  arthritis  is  the  form  usually  seen  at  first.    It  may  preserve 


Fig.  56. — Plastic  form  of  infectious  iheuiiiatism  (pseiido-anchylosis). 


its  primary  characteristics,  but  only  too  often  proves  to  be  the  fore- 
runner of  the  plastic  form,  which  develops  with  the  lapse  of  time.  If 
nothing  is  done  wasting  becomes  more  marked,  and  is  accompanied  by 
cachexia.  jThe  animals  are  unable  to  rise,  the  complications  insepar- 
able from  decubitus  occur,  and  wasting  or  secondary  purulent  infection 
sets  in. 

Lesions.     In  the  exudative  form  the  changes  are  confined  to  inflam- 


INFECTIOUS   PSEUDO-RHEUMATISM   IN   ADULTS.  103 

mation  and  thickening  of  the  synovial  memhranes,  intra-articular 
exudation,  and  sometimes  grooving  of  the  cartilages  without  ulceration 
of  the  articular  surfaces  a^nd  without  disorganisation  of  the  joint. 

The  plastic  form,  on  the  other  hand,  leads  to  destruction  of  the 
cartilages,  ligaments,  and  sub-cartilaginous  bony  layers,  induration  and 
calcification  of  the  walls  of  the  synovial  cavity,  and  even  periostitis  of  the 
ends  of  the  bones,  with  the  formation  of  false  joints.  The  internal 
surface  of  the  inflamed  synovial  membranes  begins  to  granulate,  the 
fibrous  clots  distending  the  articular  dilatations  are  perforated  by 
these  extending  granulations,  and  fibrous  tracts  soon  develop  even 
in  the  articulation  itself,  undergo  calcification,  and  produce  complete 
anchylosis. 

Diagnosis.  The  diagnosis  is  easy.  The  animal's  history  and 
symptoms,  and  the  stationary  character  of  the  pain  in  the  earlier 
stages  are  sufficient  to  prevent  any  error. 

Prognosis.  "  The  prognosis  is  grave,  but  not  fatal.  In  the  exudative 
form  recovery  may  follow  early  treatment.  In  the  plastic  form,  however, 
the  chances  of  success  are  extremely- meagre. 

Treatment.  It  is  easier  to  prevent  than  cure,  particularly  in  these 
forms  of  arthritis.  The  means  are  simple,  and  consist  in  always 
treating  the  post-partum  infection  as  soon  as  it  is  recognised.  The 
animals  can  be  effectively  safeguarded  against  later  articular  complica- 
tions by  the  free  use  of  intra-uterine  antiseptic  injections,  until  the 
uterine  injuries  have  wholly  healed,  and  by  the  administration  of  saline 
purgatives  and  diuretics. 

When  infectious  arthritis  is  diagnosed,  it  is  still  necessary  to  resort 
to  the  same  methods  if  the  uterine  symptoms  persist,  and  to  complete 
the  treatment  by  local  applications. 

The  best  method  of  local  treatment  seems  to  consist  in  puncturing 
the  articulation  aseptically,  removing  almost  all  of  the  liquid  exudate, 
and  immediately  thereafter  firing  the  skin  covering  the  joint  in  points 
or  lines. 

If  treatment  has  been  invoked  too  late,  if  plastic  arthritis  with 
the  formation  of  fibrous  bands  within  the  joint  and  destruction  of  the 
cartilages  and  calcification  of  ligaments,  etc.,  already  exists,  there  is  no 
economic  object  in  undertaking  treatment.  Fattening  may  be  attempted, 
or  the  animals  may  be  handed  over  to  the  butcher,  if  wasting  is  not  too 
far  advanced. 

The  use  of  cold  douches,  plaster  bandages,  blisters  containing  nitrate 
of  mercury,  painting  with  sulphuric  acid,  etc.,  are  too  inconvenient  and 
too  inefticient  to  be  recommended  in  actual  practice.  Similarly,  the 
salicylate  of  soda,  which  is  so  useful  in  simple  rheumatism,  has  no  real 
superiority  over  diuretics  in  this  condition. 


104  RHEUMATISM. 

SCURVY-SCORBUTUS. 

Definition.  "  Scurvy  is  a  subacute  or.  chronic  trophic  disorder 
characterised  ])y  debiHty,  inanition,  anaemia,  swelhng  and  bleeding  of 
the  gums,  gingival  ulceration,  dropping  of  the  teeth,-  and  petechial  or 
more  extensive  hfemorrhages  and  exudations  in  the  skin,  serosa,  and 
solid  tissues." 

Causes.  "  Among  the  lower  animals,  pigs  especially  suffer,  when 
kept  in  close,  foul  quarters  and  fed  on  a  monotonous  and  insufficient 
ration.  Formerly  scurvy  .  .  .  was  attributed  to  an  exclusive  diet  of 
salt  food ;  to  excess  of  sodium  and  deficiency  of  potassium  salts  ;  to  the 
absence  of  fresh  vegetables  ;  to  tainted  food,  etc.  In  pigs  the  food  and  en- 
vironment are  usually  chiefly  at  fault,  the  subjects  have  been  kept  .  .  . 
in  foul  buildings,  in  a  hot,  moist  atmosphere,  and  with  an  uniform  diet 
of  maize  or  other  unvarying  and  insufficient  ration.  Eoll  attaches 
great  importance  to  putrid  food.  Benion  has  found  the  affection 
mainly  in  obese  swine,  the  forced  feeding  and  intestinal  fermentations 
manifestly  operating  as  factors.  Hess  and  others  attribute  the  disease 
in  pigs  to  the  germ  of  erysipelas.  Stengel  has  produced  purpuric  disease 
in  animals  by  inoculation  of  the  extravasated  blood  from  human  scurvy 
patients.  Miiller  and  Babes  found  a  slender  bacillus  and  streptococci  in 
the  tissues  of  scorbutic  gums.  .  .  .  There  is  considerable  presumption 
of  the  existence  of  a  microbian  cause,  the  efficiency  of  which  is  dependent 
on  the  unhygienic  conditions  above  stated,  while  these  unwholesome 
conditions  are  equally  non-pathogenic  in  the  absence  of  the  microbe." 
Lesions.  "  The  blood  is  black  and  incoagulable  or  clots  loosely,  rigor 
mortis  is  slight,  changes  may  be  found  in  the  number  and  character  of 
the  white  and  red  blood  globules,  but  are  not  constant ;  there  is  usually 
an  excess  of  sodium  salts  and  deficiency  of  potassium  ones,  and  there  is 
marked  petechiation  of  the  skin,  mucosae  and  serosa.  The  bone  marrow 
may  be  abnormally  red  and  the  bones  fractured  at  the  epiphyses,  or 
carious.  .  .  .  The  gums  are  softened,  swollen,  red  and  uneven,  with 
hasmorrhagic  discoloration,  erosions,  necrotic  areas  and  ulcers." 

Symptoms.  "  Anorexia  or  fastidious  appetite,  prostration,  debility 
and  sluggish,  indifferent  movements,  are  followed  by  the  local  lesions  on 
the  skin  and  gums.  On  the  skin  appear  petechiae  and  extravasations, 
which  often  implicate  the  bristles,  so  that  they  may  be  shed  or  pulled 
out  with  ease,  the  bulbs  appearing  dark  and  bloodstained  (bristle  rot). 
These  may  be  followed  by  necrotic  sloughs,  and  deep  ulcers  that  are  slow 
to  heal.  The  gums  are  red  and  swollen,  with  hsemorrhagic  spots,  and 
bleed  on  the  slightest  touch.  Erosions,  sores,  and  ulcers  are  not 
uncommon ;  the  tongue  is  dry  and  furred,  and  the  mouth  exhales  a  foetid 
odour.     The  teeth  may  become  loose  in  their  sockets.     Swelling  of  the 


SCURVY — SCORBUTUS.  105 

joints  .  .  .  may  be  noticed,  and  lameness  or  stiffness  from  muscular 
or  inter-muscular  extravasation.  Blood  effusions  into  .  .  .  the  eye 
have  been  noticed,  and  paralytic  or  comatose  symptoms  from  similar 
effusions  on  the  brain.  In  the  absence  of  improvement  the  patient 
becomes  more  and  more  debilitated  and  exhausted,  and  death  may  be 
preceded  by  profuse  exhausting  diarrhoea." 

"Prognosis  is  unfavourable  in  advanced  cases,  and  when  the  faulty 
regimen  cannot  be  corrected." 

Treatment.  "  The  first  consideration  is  to  correct  the  unwholesome 
conditions  of  life,  purify  the  building  and  its  surroundings,  and  allow  a 
free  range  on  pasture.  Subject  each  patient  to  a  thorough  soapy  wash, 
and  if  possible  allow  clean  running  water  in  which  a  bath  may  be  taken 
at  will.  Access  to  green  food  and  invertebrates  (slugs,  larvse,  etc.)  is 
important,  or  a  varied  diet  of  grain,  middlings,  bran,  roots,  fruits,  tubers, 
cabbage,  silage,  etc.,  must  be  furnished.  Iron  and  bitters  (gentian,  nux 
vomica)  are  useful,  and  sometimes  small  doses  of  arsenite  of  soda  solu- 
tion or  cream  of  tartar  are  useful.  Acorns  or  horse-chestnuts  are 
recommended.  For  the  mouth  a  wash  of  potassium  chlorate,  soda 
biborate,  or  potassium  permanganate  may  be  resorted  to.  .  .  .  In 
the  case  of  fat  pigs  it  is  more  profitable  to  butcher  at  once,  as  soon 
as  early  symptoms  appear."  From  Law's  "  Veterinary  Medicine," 
p.  558,  Vol.  III. 


SECTION  II. 

DISEASES    OF    THE    DIGESTIVE    APPARATUS. 

SEMIOLOGY    OF    THE    DIGESTIVE   APPARATUS. 

The  group  of  diseases  which  affect  the  digestive  aparatus  is  one  of 
the  most  important  in  bovine  pathology,  because  ahnost  all  animals  of 
the  bovine  species  are  bred  with  the  object  of  utilising  to  the  full  their 
powers  of  digestion  and  assimilation. 

Whether  we  consider  adult  fat  animals,  calves  intended  for  slaughter 
or  milch  cows,  the  object  sought  is  always  the  same — i.e.,  to  secure  the 
greatest  possible  economic  return  through  the  medium  of  the  digestive 
functions. 

Even  although  in  working  oxen  there  is  no  tendency  to  overfeeding, 
the  animals  remain  none  the  less  predisposed  to  diseases  of  the  digestive 
apparatus;  the  meal-times  are  often  too  short,  and  rumination  has  to  be 
performed  under  the  yoke  or  during  work — in  a  word,  under  unfavourable 
physiological  conditions. 

Semiology.  To  ensure  correct  diagnosis  it  is  necessary  here,  perhaps 
more  than  in  any  other  department  -of  pathology,  to  be  capable  of  grasp- 
ing the  symptoms  or  syndromes  and  signs  afforded  by  the  different  parts 
of  the  digestive  apparatus ;  to  know  how  to  co-ordinate  and  group  them 
so  as  logically  to  deduce  the  final  synthesis,  the  diagnosis.  The  diagnosis 
]3roving  correct,  the  prognosis  becomes  easy,  and  this  is  the  chief  object 
from  the  economic  standpoint.  The  practitioner  who  undertakes  treatment 
knows  how  to  deal  with  the  case,  and  the  owner  likewise  knows  what  he 
undertakes  to  do. 

Although  this  classification  may  appear  arl)itrary,  we  shall  consider 
successively  diseases  of  the  mouth,  of  the  pharynx,  u>sophagus,  stomach, 
intestines,  etc.,  firstly  describing  the  symptoms  characterising  these 
diseases.  At  the  same  time  we  should  state  that  many  symptoms  are 
common  to  a  large  number  of  diseases  and  in  themselves  have  absolutely 
nothing  characteristic.  They  are  simply  sign-posts  capable  of  showing 
the  way. 

Mouth.  External  examination  reveals  the  condition  of  the  muzzle, 
the  lips  and   their  commissures,  and  the    surroundings  of  the  buccal 


SEMIOLOGY   OF   THE   DIGESTIVE   APPARATUS. 


107 


opening,  and  detects  the  existence  of  any  desquamation,  rents,  eruptions, 
ulcerations,  etc.,  which  may  be  present. 

In  quiet  aijimals  the  practitioner  can  examine  the  cavity  of  the  mouth 
single-handed,  hut  in  troublesome  animals  it  becomes  necessary  to  have 
an  assistant,  who  seizes  the  muzzle  with  one  hand  and  the  tongue  with 
the  other,  or  who  simply  fixes  the  animal's  head.  In  exceptional  cases 
it  will  be  necessary  to  secure  the  patient  to  a  post,  tree,  or  wall.  The 
mere  attempt  at  examination  will  show  whether  there  is  trismus  or 
absolute  freedom  of  movement  in  the  jaws. 

By  introducing  the  fingers  between  the  commissures  and  applying 
them  to  the  bars  or  to  the  free 
portion  of  the  tongue,  the  prac- 
titioner will  be  able  approxi- 
mately to  estimate  the  local  and 
general  temperature.  The  sen- 
sations experienced  will  also 
inform  him  of  the  degree  of 
moisture  or  dryness  of  the 
mouth  and  of  its  sensibility. 

On  separating  the  jaws,  he 
will  note  the  odour  exhaled  and 
its  possible  abnormalities — its 
acid,  sourish,  foetid,  or  putrid 
character.  He  will  directly  ob- 
serve any  anaemia  or  hyper- 
remia  of  the  mucous  membrane, 
from  the  inner  surface  of  the 
lips  and  cheeks  up  to  the  soft 
palate,  although  owing  to  the 
thickness  of  the  buccal  epithe- 
lium it  is  not  always  easy  to 

estimate  anaemia  or  hyperemia  in  the  ox.  The  surface  of  the  tongue 
should  also  be  examined,  and  a  note  made  whether  it  appear  dry,  pasty, 
dusty,  sooty,  etc.,  though  these  appearances  are  occasionally  apt  to  lead 
one  astray.  The  observer  should  also  inquire  regarding  want  of  appetite, 
depraved  or  exaggerated  appetite,  etc. 

Even  the  manner  in  which  the  animal  picks  up  its  food  will  serve 
to  direct  his  attention  to  the  development,  or  possible  existence,  of  some 
disease  of  the  mouth,  although  want  of  appetite  is  not  always  charac- 
teristic of  a  lesion  in  the  pharynx  or  oesophagus,  but  sometimes  of  a 
lesion  in  its  neighbourhood,  like  hypertrophy  of  the  retropharyngeal  or 
bronchial  lymphatic  glands. 

This  examination  will  also  detect  the  existence  on  the  lips  of  wounds, 


Fig.  57. — Examination  of  the  mouth. 


108 


DISEASES   OF   THE   DIGESTIVE   APPARATUS. 


cuts,  injuries  or  specific  eruptions  (aphtha,  tuberculous  ulcerations,  the 
ulcerations  of  gangrenous  coryza,  etc.)  on  the  gums  indications  of 
gingivitis,  periostitis,  mercurial  poisoning,  actinomycosis  of  the  maxilla, 
and  ulcerations  of  all  kinds ;  on  the  tongue,  of  wounds,  of  simple  or 
specific  inflammatory  eruptions  (aphtha,  the  ulcerations  of  actinomycosis, 
tuberculosis,  gangrenous  coryza,  etc.),  as  well  as  the  swellings  due  to 
superficial  or  deep-seated  glossitis.  By  the  same  method  of  examination,  • 
though  with  somewhat  more  difficulty,  one  can  detect  abnormal  mobility, 
irregularity  of  development,  caries,  etc.,  of  the  teeth,  the  condition  of 
the  excretory  ducts  of  the   salivary  glands,  the  state  of  the  hard  and 

soft  palate,  and  the  existence  of 
fissures,  vegetations,  polypi  and 
tumours. 

Salivary  glands.  The  salivary 
glands,  particularly  the  parotid  and 
submaxillary,  should  be  examined 
by  direct  inspection  and  palpation. 
Direct  inspection  reveals  the 
existence  of  swellings,  deformity 
of  parts,  increase  in  salivation,  or 
ptyalism,  which  sometimes  occur 
in  conjunction  with  foot-and- 
mouth  disease,  actinomycosis, 
acute  stomatitis  and  mercurial 
poisoning,  as  well  as  increase  in 
size  of  the  salivary  ducts. 

Palpation  reveals  the  degree 
of  sensibility  of  the  parts,  the 
existence  of  crdema,  induration, 
cysts,  and,  more  frequently,  distension  of  the  salivary  ducts  as  well  as 
the  presence  of  calculi,  tumours,  the  direction  of  fistulae,  etc. 

Difficulties  may  occur,  particularly  when  the  submaxillary  and  parotid 
glands  are  affected  ;  but  methodical  and  complete  examination  will  usually 
enable  one  to  differentiate  the  conditions. 

Pharynx.  The  pharnyx  may  be  examined  externally  by  inspection 
and  palpation,  and  internally  by  direct  digital  palpation.  Inspection 
reveals  possible  deformities  of  the  region  of  the  gullet,  palpation  the 
condition  of  the  tissues  as  well  as  abnormal  sensibility  and  infiltration. 
Internally,  digital  examination  must  be  cautiously  conducted,  and  after 
a  strong  gag  has  been  securely  inserted  in  the  mouth.  Under  such  con- 
ditions it  is  without  danger.  The  hand  being  inserted  exactly  in  the 
median  line  will  detect  obstructions  which  may  already  have  been  partly 
identified  by  external  palpation,  as  well  as  the  existence  of  inflammation 


Fig.  58. — Examination  of  the  mouth 


SEMIOLOGY   OF   THE   DIGESTIVE   APPARATUS. 


109 


with  or  without  the  formation  of  false  membranes,  and  of  ulcerations, 
polypi,  etc. 

(Esophagus.  In  consequence  of  its  anatomical  formation,  situation 
and  course,  the  oesophagus  may  be  divided  into  two  distinct  parts — viz., 
the  cervical,  which  can  be  examined  from  the  outside,  and  the  thoracic, 
which  cannot  so  be  examined. 

The  cervical  part  may  be  examined  by  inspection,  by  palpation  from 
one  side,  or  by  palpation  with  both  hands  and  from  both  sides. 

Inspection  leads  to  the  detection  of  changes  in  the  shape  of  the 
oesophagus  and  of  the  jugular  furrow.     In  fat  subjects,  however,  it  is  of 


Fig.  59. — Examination  of  the  phaiynx. 


little  value.  As  the  position  and  the  course  of  the  oesophagus  are  known, 
unilateral  palpation,  or,  better  still,  bilateral  palpation,  employing  both 
hands,  is  of  very  nnich  greater  service.  These  methods  reveal  the 
presence  of  swellings,  infiltrations,  changes  in  shape  and  sensibility,  the 
presence  of  foreign  bodies,  the  existence  of  dilatations  or  contractions 
of  the  tube,  etc. 

Auscultation  and  percussion,  though  recommended  by  some  prac- 
titioners, are  not  of  much  service. 

Inability  to  swallow,  due  to  change  in  the  oesophagus,  is  also  detected 
by  inspection.  Its  existence  suggests  a  number  of  jjossible  conditions, 
such  as  fissure  or  ulceration  of  the  oesophagus,  compression  in  the 
mediastinal  region  as  a  result  of  tuberculous  or  other  disease,  contraction 
or  dilatation  of  the  oesoiduigus,  etc.     Furthermore,  inspection  will  betray 


110  DISEASES    OF   THE    DIGESTIVE    APPARATUS. 

the  existence  of  dilatation  of  the  tul)e,  to  which  vomiting  and  regurgitation 
of  food  are  sometimes  due. 

Internal  exploration  is  the  only  method  of  detecting  changes  in  the 
thoracic  portion,  and  may  also  be  utilised  to  locate  lesions  in  the  cervical 
region.  It  is  practised  by  passing  a  sound  of  small  calibre  or  any 
flexible  cylindrical  object,  such  as  a  cart  rope,  etc.  The  patient  must  be 
fixed  with  the  head  extended  on  the  neck  and  a  proper  gag  or  speculum 
introduced  into  the  mouth.  Exploration  assists  us  in  recognising  the 
existence  of  inflammation  of  the  oesophagus,  true  or  false  contraction, 
dilatation  and  the  presence  of  obstructions. 

In  animals  of  the  bovine  species  all  these  lesions — viz.,  inflammation 
of  the  oesophagus,  fissuring  and  ulceration,  obstructions,  compressions, 
dilatations  and  contractions  of  the  tube — although  not  very  frequent, 
are  nevertheless  from  time  to  time  encountered. 

Stomach.  Exploration  of  the  stomach  or  of  the  different  gastric 
compartments  presupposes  an  exact  knowledge  of  the  respective  positions 
of  the  different  reservoirs.  Topographical  anatomy  shows  that  the  rumen 
is  situated  in  the  left  flank,  and  that  it  occupies  the  whole  of  the  left 
abdominal  region  from  the  diaphragm  to  the  pelvic  cavity.  As  a  con- 
sequence, it  may  be  explored  from  the  region  of  the  twelfth  rib  ;  it  is 
inclined  slightly  from  above  downwards,  and  from  left  to  right,  its  ex- 
treme right  border  extending  as  far  as,  or  a  little  beyond,  the  white  line. 

The  reticulum,  the  smallest  of  the  four  reservoirs,  is  situated  in  the 
sub-ensiform  region  at  right  angles  to  the  median  plane  of  the  body.  On 
the  left  it  touches  the  rumen  and  the  diaphragm  ;  on  the  right  side  it 
is  in  contact  in  front  with  the  diaphragm,  above  with  the  omasum,  and 
to  the  right  and  towards  the  rear  with  the  abomasum.  The  omasum  is 
situated  above  the  reticulum  and  conical  right  portion  of  the  rumen  ; 
in  front  it  touches  the  liver,  and  towards  the  back  and  left  the  rumen. 
The  abomasum  is  situated  obliquely  in  the  right  hypochondriac  region, 
its  anterior  surface  resting  on  the  lower  wall  of  the  abdomen  towards  the 
middle  and  right  side  of  the  body,  its  pyloric  portion  extending  upwards, 
behind  the  right  hypochondriac  region. 

Rumen.  The  rumen  can  be  examined  by  inspection,  palpation,  per- 
cussion, and  auscultation.  The  use  of  the  oesophageal  sound  and  of  the 
trocar  and  canula  is  also  of  value  in  diagnosis. 

Inspection  affords  information  of  a  varying  character,  according  to 
the  moment  when  it  is  practised,  even  in  a  condition  of  health.  It  only 
extends  to  the  condition  of  the  flank  before  or  after  a  meal,  etc.,  empti- 
ness of  the  rumen  being  accompanied  by  hollowness  of  the  flank,  and 
distension,  following  an  abundant  meal,  by  fulness  in  this  region. 

When  digestion  is  not  proceeding  normally,  the  flank  may  be  distended 
unduly  by  gaseous  accumulations  or  by  the  presence  of  solid  food.      In 


SEMIOLOGY   OF   THE   DIGESTIVE   APPAKATUS. 


Ill 


abdominal  and  mediastinal  tuberculosis  and  in  gastro-enteritis  there  may 
be  simple  tension  or  slight  dilatation.     "When  indigestion  or  enteritis  is 


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entering  on  a  favourable  stage,  the  flank  may  appear  hollow,  and  in  cases 
of  chronic  diarrhoea  it  may  a^^pear  retracted. 


112  DISEASES   OF   THE   DIGESTIVE   APPAKATUS. 

Digital  examination  or  palpation  may  be  practised  over  the  entire 
region  of  the  flank.  It  shows  whether  the  rmuen  is  full  or  empty, 
reveals  the  consistence  of  the  contained  food  in  cases  of  chronic  indiges- 
tion, the  sensibihty  of  the  walls,  and  the  rate  and  order  of  the  muscular 
contractions.  Direct  or  indirect  percussion  maybe  carried  out  on  a  hori- 
zontal line  from  the  twelfth  rib  as  far  back  as  the  flank,  and  vertically 
from  the  lumbar  vertebrae  to  the  white  line.  In  health  one  discovers  in 
young  animals  an  upper  zone  of  normal  resonance  due  to  gas,  a  zone  of 
semi-dulness  and  an  inferior  zone  of  absolute  dulness,  due  to  the  liquids 
in  the  rumen.  The  spleen,  wdiich  is  attached  to  the  supero -anterior  sur- 
face of  the  left  side  of  the  rumen,  does  not  seriously  restrict  the  area 
open  to  percussion. 

In  pathological  conditions  percussion  from  above  downwards  may  pro- 
duce a  tympanitic  sound,  due  to  gaseous  indigestion  or  a  clear  sound 
throughout  the  greater  portion  of  the  vertical  diameter  suggestive  of 
acute  gastro-enteritis  with  the  formation  of  gas  in  the  rumen,  or  of 
adhesive  peritonitis  preventing  the  rumen  from  collapsing.  Indigestion 
due  to  excess  of  solid  food,  on  the  contrary,  is  characterised  by  a  dull 
sound  throughout  the  entire  region  from  above  downwards.  Percussion 
along  a  horizontal  line  permits  of  the  delimitation  of  certain  zones  which 
vary  a  great  deal  in  area,  according  to  the  case. 

Auscultation  is  more  instructive  than  percussion.  Like  percussion,  it 
may  be  practised  throughout  the  entire  depth  of  the  abdomen,  from  the 
transverse  processes  of  the  lumbar  vertebrae  as  far  as  the  white  line,  and 
in  a  horizontal  direction  from  the  eleventh  rib  to  the  region  of  the  flank. 

Auscultation  of  the  upper  zone  enables  one  to  detect  sounds  of 
deglutition,  gurgling  sounds  (glou-giou),  and  a  sound  resembling  falling 
w'ater,  due  to  the  movement  of  solids  or  liquids  in  the  rumen  and 
reticulum.  The  sounds  heard  vary  in  different  cases,  and  depend  on 
the  state  of  repletion  or  of  emptiness  of  the  rumen. 

Auscultation  of  the  middle  zone  reveals  : 

Firstly,  a  very  special  crepitation  sound,  which  may  be  compared  to 
the  deflagration  of  a  handful  of  salt  thrown  on  burning  coal.  It  is 
believed  to  result  from  the  bursting  of  bubbles  in  the  contents  of  the 
rumen  under  the  action  of  normal  digestion. 

Secondly,  a  churning  sound  produced  by  the  rhythmic  peristaltic 
contractions  of  the  rumen,  by  which  the  substances  ingested  are  very 
intimately  mixed.  By  applying  the  ear  over  the  flank  region  or  by 
palpation  the  rhythmic  contractions  of  the  rumen,  two  per  minute  in 
most  cases,  can  readily  be  perceived. 

In  practice  examination  of  the  rumen  is  confined  to  these  four  methods. 

Puncture.  From  an  exclusively  scientific  point  of  view,  exploration  of 
the  rumen  also  comprises  analysis  of  the  gas  collected  through  puncture 


SEMIOLOGY   OF   THE    DIGESTIVE    APPARATUS.  113 

and  analysis  of  the  liquids  removed  by  aspiration  (first  stages  of  gastric 
digestion).  Normally,  these  gases,  in  the  order  of  their  abundance  in  the 
mixture,  consist  of  the  follo^Ying :  Carbonic  acid,  carburetted  hydrogen 
and  nitrogen. 

In  disease,  and  in  most  cases  of  abnormal  fermentation,  the  carbu- 
retted hydrogen  is  greatly  in  excess  of  the  carbonic  acid.  In  chronic 
gastro-enteritis,  ammonium  sulphide  and  other  offensive  gases  are  found 
in  addition. 

Chemical  analysis.  In  the  rumen  the  ingested  food  is  macerated  in 
an  alkaline  liquid  at  a  temperature  of  100°  to  101°  Fahr.  (the  alkalinity 
is  due  to  the  saliva) ,  This  process  markedly  modifies  the  composition  of 
the  ingested  matter.  Nevertheless,  the  upper  portion  in  contact  with  the 
gas  sometimes  presents  a  slightly  acid  reaction,  probably  due  to  carbonic 
acid.  The  sugary  and  fatty  materials  contained  in  the  food  respectively 
undergo  lactic  and  butyric  fermentation.  Only  a  small  quantity  of  the 
starch,  however,  is  transferred  into  sugar.  In  the  calf,  and  in  very  young 
animals,  the  reaction  of  the  rumen  is  acid  throughout  the  entire  period 
of  sucking.  In  disease,  when  rumination  has  long  been  suspended  and 
chronic  loss  of  appetite  or  gastro-enteritis  exists,  the  reaction  is  generally 
acid.  The  sugars,  gums,  and  soluble  salts  of  forage,  roots,  etc,  are  dis- 
solved in  the  rumen,  but  fatty  materials  undergo  no  modification. 

The  reticulum,  which  is  the  smallest  of  the  gastric  compartments,  is 
situated  in  the  sub-ensiform  and  retro-diaphragmatic  regions,  extending 
right  and  left  of  the  middle  line  to  a  nearly  equal  distance.  Above  and 
to  the  left  it  communicates  freely  with  the  rumen,  to  the  right  with  the 
omasum. 

In  practice  it  can  only  be  examined  in  two  ways  :  inspection  and 
palpation. 

By  inspection  changes  in  the  configuration  of  the  ensiform  region 
may  sometimes  be  detected.  Such  changes  are  rare,  and  must  be  dis- 
tinguished from  congenital  deformity.  They  sometimes  accompany 
inflammation  of  the  reticulum  produced  by  a  foreign  body,  when  the 
lower  abdominal  wall  is  directly  perforated  by  such  body. 

In  cases  of  inflammation  of  the  reticulum  due  to  foreign  bodies, 
abscess  formation,  perforation,  etc.,  it  is  possible  to  detect  cedematous 
infiltration,  abnormal  sensibility,  fluctuation  and  increased  heat,  etc.,  by 
manipulating  the  parts  with  the  fingers  or  the  clenched  fist. 

If  the  evidence  pointing  to  the  presence  of  a  foreign  body  in  the 
reticulum  is  considered  sufficient,  gastrotomy  may  be  performed  and  the 
interior  of  the  viscus  examined  with  the  hand,  but  although  the  operation 
is  i^ossible  it  is  very  rarely  practised. 

Omasum.    The  omasum  occupies,  so  to  speak,  a  position  inverse  to  that 

D,C.  .  I 


114  DISEASES   OF   THE    DIGESTIVE    APPARATUS. 

of  the  reticulum,  lying  deep  down  on  the  right  side,  behind  the  diaphragm, 
under  the  hypochondrium,  and  above  the  abomasum  and  reticulum. 

It  is  the  only  gastric  compartment  which  cannot  be  examined,  although 
when  impacted  it  may  be  felt  on  the  right  side. 

Abomasum.  The  abomasum  is  lodged  in  the  lower  part  of  the  right 
flank  under  the  circle  of  the  hypochondrium.  It  extends  obliquely  from 
below,  upwards  from  the  sub-ensiform  to  the  sub-lumbar  region.  The 
smaller  curvature  is  turned  towards  the  rumen  on  the  left  side ;  the  larger 
curvature  is  in  contact  with  the  abdominal  wall.  In  spite  of  what  has  so 
often  been  stated  by  those  who  have  never  seen  it,  the  abomasum  can  be 
examined  and  is  accessible  along  the  circle  of  the  hypochondrium. 

In  adults  useful  information  can  rarely  be  obtained  by  inspection ; 
but  in  sucking  calves  the  abomasum,  if  distended  by  indigestion,  gastro- 
enteritis, etc.,  sometimes  appears  prominently  in  the  right  abdominal 
region.  Palpation  with  the  fingers  or  with  the  fist  will  detect  exag- 
gerated sensibilty,  irritation,  inflammation,  or  distension. 

Percussion  and  auscultation  furnish  no  very  precise  information.  The 
information  obtained  by  the  above-described  examination  of  the  stomach 
is  in  practice  amplified  by  a  search  for  certain  symptoms  which  are  usually 
easy  to  detect.     They  comprise : 

(a)  Suppression  or  irregularity  of  rumination.  This  very  important 
symptom  suggests  the  degree  of  gravity  of  the  digestive  disturbance,  and 
to  some  extent  the  gravity  of  the  general  condition.  Suppressed  rumina- 
tion is  a  common  symptom  in  many  diseases,  some  of  which  are  purely 
digestive,  though  all  are  not.  It  is,  however,  a  grave  sign  in  most  cases, 
{h)  Eructation,  which  is  usually  frequent,  may  be  regarded  as  normal 
provided  the  exhaled  gas  preserves  the  fresh  odour  of  grass  or  of  the  food 
swallowed,  like  brewers'  grains,  turnips,  etc.  Sometimes  the  gas  is  sour, 
acid,  foetid,  or  putrid,  all  of  which  conditions  indicate  disease. 

(c)  Yawning  is  not  common.  It  becomes  frequent  and  attracts 
attention  in  certain  abnormal  conditions  ;  in  others,  again,  it  may  be 
completely  suppressed. 

(d)  Nausea  and  vomiting  are  rare.  Vomiting  is  commoner  in  calves, 
and  results  from  inabihty  to  digest  the  milk,  or  simply  to  over-distension 
of  the  abomasum.  The  matter  vomited  by  adults  usually  consists  of 
partly  masticated  food,  and  is  derived  from  the  rumen ;  while  the  con- 
tents of  the  abomasum  are  occasionally  rejected,  in  which  case  the 
material  is  of  pulpy  consistence  and  has  an  acid  smell. 

(e)  Digestive  disturbance  is  sometimes  accompanied  by  various  modi- 
fications in  the  breathing,  such  as  immobilisation  of  the  hypochondriac 
region  and  of  the  diaphragm ;  abnormal  sensibility  and  reflex  coughing 
on  palpation,  and,  in  inflammation  of  the  reticulum  due  to  foreign 
bodies,  costal  respiration. 


SEMIOLOGY  OF   THE   DIGESTIVE   APPARATUS. 


115 


Vc.o 


Gi 


Fig.  61. — Position  of  the  iUxloniinal  \iscera,  scon  from  below.  Gi,  large  intestine; 
Y.c.f/.,  left  pouch  of  the  rumen  ;  E,  E,  epiploon  (line  of  insertion)  ;  P,  paunch  or 
rumen;  A j;,  xyphoid  appendix  of  the  sternum  ;  E,  reticulum  ;  C,  abomasum;  Y.c.iL, 
right  pouch  of  the  rumen  ;  Ig,  small  intestine. 

I  2 


116  DISEASES   OF   THE    DIGESTIVE    APPARATUS. 

It  is  by  metliodiGiilly  observing,  grouping,  and  classifying  the 
symptoms  presented  that  one  is  enal)led  to  detect  the  Hnks  connecting 
them. 

Intestine.  The  intestinal  mass  is  contained  in  the  right  half  of  the 
abdomen  above  the  compartment  of  the  stomach.  The  large  intestine 
occupies  the  upper  zone,  corresponding  externally  with  the  hollow  of 
the  flank  from  the  thirteenth  rib  to  the  haunch.  The  small  intestine 
occupies  the  middle  zone  from  the  thirteenth  rib  to  the  entrance  to  the 
pelvis  and  the  stifle  region  ;  the  inferior  zone  is  occupied  by  the  rumen 
and  abomasum,  and  in  pregnant  females  by  the  gravid  uterus. 

Notwithstanding  these  indications  it  is  somewhat  difficult  to  examine 
the  mass  of  the  large  intestine,  separated  as  it  is  from  the  abdominal  wall 
by  the  U-shaped  inflection  of  the  duodenal  loop,  of  which  the  deep  retro- 
grade branch  is  in  contact  with  the  terminal  portion  of  the  floating  colon. 

Inspection  of  the  right  flank  furnishes  no  information  of  value 
in  diseases  of  the  intestine,  nor  is  auscultation  of  much  service  beyond 
enabling  one  to  detect  the  frequency,  diminution,  or  absence  of  bor- 
borygmus.  Palpation  alone  is  really  of  service.  Practised  gently  and 
superficially  with  the  tips  of  the  fingers  it  detects  abnormal  sensibility 
in  acute  cases  of  enteritis  ;  when  with  more  energy,  palpation  reveals 
whether  the  bowel  be  full  or  empty,  provided  that  the  muscular  resis- 
tance be  not  too  marked. 

Colic.  In  colic  the  clinical  signs,  their  varieties,  and  the  lesions  which 
give  rise  to  them  are  of  much  more  importance.  When  it  results  from 
intestinal  congestion  a  frujore  (due,  for  example,  to  the  ingestion  of  cold 
water),  colic  is  usually  violent,  sudden,  and  of  relatively  short  duration. 
In  other  cases  it  is  violent  and  prolonged  for  several  hours,  a  whole  day, 
or  even  two  days,  and  may  be  followed  by  coma  and  suppressed  peristalsis ; 
it  then  indicates  invagination,  volvulus,  or  strangulation.  Sometimes,  on 
the  contrary,  it  remains  dull  and  is'  slow  and  continued  (acute  gastro- 
enteritis, hfemorrhagic  gastro-enteritis,  etc.). 

Finally,  colic  of  the  latter  character  may,  in  addition,  be  accompanied 
by  icterus,  in  cases  of  retention  of  bile,  biliary  calculi,  hepatitis,  etc. 

Anus.  Examination  of  the  anus  is  easy.  Simple  inspection  reveals 
its  presence  or  absence,  and  consequently  the  existence  of  congenital 
rectal  atresia,  which  is  somewhat  common  in  calves  and  colts.  Digital 
exploration  is,  however,  sometimes  useful,  for  in  occasional  cases  an  anus 
may  exist,  which  externally  appears  normal,  but  terminates  in  a  sac,  the 
rectum  being  closed  by  a  membranous  partition. 

Nothing  is  easier  to  recognise  than  tenesmus ;  it  occurs  in  cases  of 
profuse  diarrhoea,  diarrhoea  of  calves,  and  dysentery  in  newly-born 
animals. 

Rectal  exploration.     Exploration  of    the  rectum  is  a  last  and  most 


SEMIOLOGY   OF   THE    DIGESTIVE    APPARATUS. 


117 


valuable  means  of  coiifirming  the  diagnosis  in  all.  visceral  diseases  of  the 


"id 


pelvis  and  abdomen.     To  utilise  this  method  to  the  full,  the  rectal  pouch 


118  DISEASES   OF   THE    DIGESTIVE    APPARATUS. 

should  first  be  thoroughly  emptied  by  the  free  use  of  enemata,  the 
subsequent  examination  being  made  with  great  care.  The  animal's  hind 
legs  being  secured,  the  operator  smears  his  hand  and  forearm  with  some 
fatty  substance,  and,  forming  the  fingers  into  a  cone,  introduces  them 
with  gentle  pressure  through  the  anus,  the  palm  of  the  hand  being  turned 
downwards.  Passing  the  hand  gently  along  the  rectum,  the  operator 
will  be  able  to  distinguish  the  conical  posterior  pouches  of  the  rumen, 
the  loop  of  the  duodenum,  the  mass  of  convolutions  of  the  small  intes- 
tines and  of  the  colon,  etc.  Next,  he  will  examine  the  vagina,  uterus, 
bladder,  ureters,  kidneys,  aorta,  and  the  pelvic  and  sub-lumbar  lymphatic 
glands.  He  may  be  able  to  recognise  distension  of  the  rumen  with  food, 
twists  of  the  intestine,  hernia,  mesenteric  or  diaphragmatic  invagination 
or  volvulus  of  the  bowel,  etc. 

In  other  cases  he  may  be  able  to  discover  lesions  of  the  kidney,  of  the 
uterus,  of  the  broad  uterine  ligaments,  of  the  ovaries,  or  of  vessels. 

In  all  cases  it  is  desirable  to  make  a  methodical  and  complete 
examination,  whatever  the  primary  object  may  have  been.  Such 
an  examination  may  be  carried  out  as  follows :  The  operator  having 
introduced  his  hand  into  the  rectum,  begins  by  examining  the  state 
of  the  pelvic  organs,  the  rectum,  base  of  the  vagina,  the  body  and 
horns  of  the  uterus,  the  bladder  and  the  lymphatic  glands  and  ligaments 
of  the  pelvis. 

By  laying  the  hand  flat  in  the  rectum  and  pressing  gently  downwards 
the  anterior  border  of  the  j)ubis  may  be  felt,  somewhat  more  deeply 
placed.  The  rectum  is  then  thrust  slightly  to  the  right,  and  the 
ascending  branch  of  the  right  ilium,  as  high  as  the  sacro-iliac  articula- 
tion, and  the  lower  surface  of  the  sacrum,  are  directly  examined ;  lastly, 
the  hand  is  directed  towards  the  left,  gliding  down  the  left  ilium,  and 
returning  to  the  point  of  departure.  In  this  way  the  state  of  the  pelvic 
floor,  of  the  arteries,  veins,  and  lymphatic  glands,  etc.,  the  degree  of 
mobility,  tension,  or  fulness  of  the  uterus,  as  well  as  the  condition  of  the 
broad  ligaments,  are  all  ascertained. 

Still  more  deeply  placed,  and  at  the  extreme  limit  to  which  the  arm 
can  be  introduced,  will  be  found  some  or  all  of  the  above-mentioned 
organs — viz.,  the  small  intestine,  large  intestine,  kidney,  etc. 

Defaecation:  Examination  of  the  faecal  material.  The  character  of 
the  faices  is  very  important  in  certain  diseases ;  e.g.,  diarrhoea  assumes  a 
varying  importance,  according  as  the  discharges  are  of  an  alimentary, 
serous,  mucous,  or  sanguinolent  type,  and  are  slight,  temporary,  intense, 
profuse,  or  continued.  In  other  cases  defiecation  is  slow,  becomes  diffi- 
cult, and  various  degrees  of  constipation  exist.  Defecation  may  be 
completely  sujjpressed,  as  in  invagination  or  strangulation  of  the  intes- 
tines ;  on  the  otber  hand,  one  may  observe  diarrhoea,  dysentery  (microbic 


SEMIOLOGY    OF    THE    DIGESTIVE    APPARATUS.  119 

or  sporozoic  diarrhoea),  and  intestinal  hgemorrhage.  The  last-named  may 
be  of  varying  degrees  of  acuteness,  from  the  passage  of  simple  drops  or 
streaks  of  blood,  distributed  over  almost  normal  excreta,  to  the  passage 
of  unchanged  blood  in  liquid  jets  or  in  clots. 

Macroscopic  examination.  Macroscopic  examination  takes  cognis- 
ance, firstly,  of  the  quantity  (40  to  80  lbs.),  consistence  (firmness  or  soft- 
ness), colour  (olive  green,  blackish  green,  greyish  black,  sooty,  or  tarry) 
and  odour  (normal,  foetid,  putrid,  etc.)  of  the  faeces. 

Sometimes  the  excreta  are  moulded  and  covered  with  glairy  mucus, 
or  contain  such  abnormal  products  as  undigested  food  (a  sign  of 
chronic  diarrhtea),  false  membranes,  false  membranes  due  to  pseudo- 
membranous enteritis,  fibrinous  clots,  or  parasites  like  liver  flukes,  tfenite 
and  strongyles. 

Microscopic  examination.  Microscopic  and  bacteriological  examina- 
tion is  sometimes  useful ;  and  even  when  macroscopic  examination  has 
revealed  nothing,  it  is  possible  to  detect  the  presence  of  the  eggs  of 
parasites  like  flukes,  strongyles,  hooked  worms,  etc.,  the  presence  of 
sporozoa  (as  in  intestinal  coccidiosis)  and  of  specific  microbes,  as  in  the 
diarrhcea  of  calves,  etc. 

It  is  only  by  the  synthesis  of  methodically  collected  signs  that 
one  finally  succeeds  in  exactly  diagnosing  the  numerous  diseases  which 
may  aft'ect  the  intestine :  intestinal  congestion,  invagination,  volvulus, 
intestinal  strangulation  (mesenteric  or  diaphragmatic  hernia,  etc.), 
atresia  of  the  anus,  acute  or  htemorrhagic  enteritis,  or  intestinal 
helminthiasis. 

Liver.  The  liver  is  situated  in  the  right  sub-lumbar  region.  It  is 
fixed  behind  the  diaphragm  and  under  the  hypochondriac  region,  and 
extends  from  the  ninth  to  the  thirteenth  rib.  It  can  be  examined  by 
palpation  through  the  last  intercostal  spaces  and  behind  the  thirteenth 
rib.  In  health  it  is  difiicult  to  pass  the  fingers  sufiiciently  under  the 
hypochondriac  circle  to  reach  the  liver;  but  in  case  of  morbid  hyper- 
trophy it  extends  more  or  less  beyond  the  last  rib,  and  palpation  be- 
tween the  last  ribs  sometimes  reveals  abnormal  sensibility. 

Percussion  better  than  palpation  enables  one  to  delimit  the  space 
occupied  by  the  liver,  particularly  towards  the  back,  where  there  is  no 
interposed  layer  of  lung.  Percussion  is  especially  useful  in  detecting 
hypertrophy  due  to  cancer,  tuberculosis,  echinococcosis  of  the  liver,  etc., 
or  hepatic  atrophy.  In  isolated  cases  icterus  may  exist,  confirming  the 
conclusions  otherwise  arrived  at. 

Pancreas.  The  pancreas  is  situated  rather  deeply  in  the  right  sub- 
lumbar  region,  below  the  kidney,  behind  the  liver,  above  the  floating 
colon,  and  within  the  duodenal  loop.  It  is  therefore  very  difficult  to 
examine ;  moreover,  the  diseases  which  affect  it  are  still  little  understood. 


120  DISEASES    OF    THE    DIGESTIVE    APPARATUS. 

The  point  most  prominently  brought  forward  by  this  demonstration 
of  the  topographical  anatomy  and  semiology  of  the  digestive  apparatus 
is  the  difficulty  of  accm-ately  diagnosing  digestive  diseases  in  the  ox  when 
one  confines  oneself  to  a  superficial  examination.  To  have  any  chance 
of  arriving  at  an  exact  diagnosis,  methodical  and  thorough  examination 
is  indispensable.  Given  this  condition,  accurate  diagnosis  becomes 
possible,  despite  all  difficulties. 


CHAPTER    I. 
DISEASES    OF   THE    MOUTH. 

STOMATITIS. 

Definition.  By  stomatitis  we  mean  inflammation  of  the  buccal 
mucous  membrane.  Stomatitis  may  be  simple — i.e.,  due  to  accidental 
causes,  to  varying  local  forms  of  irritation,  or  to  wounds ;  or,  on  the 
contrary,  it  may  be  specific,  of  infectious  origin,  like  the  stomatitis 
of  foot-and-mouth  disease,  gangrenous  coryza,  cattle  plague,  etc.; 
or,  finally,  it  may  be  of  toxic  origin,  like  the  stomatitis  of  mercurial 
poisoning. 

Here  we  shall  only  study  the  simple  forms  of  stomatitis,  the 
gangrenous  stomatitis  of  calves,  and  mercural  stomatitis.  The  others 
will  be  noticed  in  speaking  of  the  diseases  of  which  they  form  one  of 
the  symptoms. 

SIMPLE    STOMATITIS. 

Causation.  Simple  stomatitis  of  bovine  animals  is  often  due  to 
feeding  with  rough  forage,  or  forage  containing  prickly  or  spiny  plants, 
like  thistles,  sea  holly,  eryngo,  etc.  Sometimes  it  follows  prolonged 
irritation  by  rough  teeth,  premolars  or  stumps,  or  accompanies  the  shed- 
ding of  the  temporary  molars.  Ingestion  of  irritant  plants  like  nettles, 
certain  specimens  of  the  orders  Lahiatre  and  Umhelliferce,  leaves 
covered  wdth  vesicant  insects,  cabbage  and  turnip  leaves  infested  with 
aphides,  oil  beetles,  etc.,  or  the  swallowing  of  hot  liquids,  may  also, 
though  more  rarely,  produce  it.  Finally,  in  grave  diseases  of  the  diges- 
tive apparatus,  the  buccal  mucous  membrane  may  secondarily  become 
affected. 

Symptoms.  The  primary  symptoms  are  usually  represented  by 
ptyalism  and  a  certain  difficulty  in  grasping  food.  In  other  cases  the 
mucous  membrane  appears  slightly  dry  for  some  time  before  salivation 
sets  in.  On  introducing  the  fingers  into  the  animal's  mouth  some 
elevation  of  temperature  may  be  noted,  and  on  direct  inspection  the 
non-pigmented  regions  are  seen  to  be  abnormally  vascular,  a  fact  which 


122  DISEASES   OF   THE   MOUTH. 

has  earned  for  this  form  of  stomatitis  the  names  of  "  erythematous " 
and  "  erysipehitous  stomatitis." 

If  the  stomatitis  is  due  to  local  multiple  irritation,  such  as  results 
from  spines  and  prickles  in  the  food,  the  ahnormal  vascular  appearance 
is  confined  to  the  neighbourhood  of  the  abrasions  or  punctures,  and  the 
affected  regions  are  of  very  varying  size.  In  some  cases,  principally  as  a 
consequence  of  trilling  local  irritation  and  of  burns  of  the  first  and 
second  degree,  blisters  of  varying  size  may  develop  and  break,  leaving 
behind  ulcerations,  which,  however,  always  heal  rapidly.  The  aphthous 
non-contagious  stomatitis  mentioned  by  certain  authors  seems  most 
probably  to  pertain  to  this  class. 

Diagnosis.  The  diagnosis  is  usually  easy,  and  a  little  attention  to 
the  accompanying  symptoms  is  sufficient  to  avoid  confusion  with  the 
various  forms  of  symptomatic  stomatitis. 

The  prognosis  is  favourable. 

Treatment  is  based  on  removal  of  the  determining  cause,  if  this  can 
be  recognised,  withdrawal  of  rough  forage,  removal  of  sharp  points  on 
the  teeth,  extraction  of  stumps,  etc.  As  a  rule,  recovery  follows  rapidly. 
It  can  be  hastened  by  washing  out  the  mouth  directly,  or  by  means  of  a 
syringe,  with  water  containing  honey,  vinegar,  decoctions  of  brier  twigs, 
oak  bark,  barley  or  rice.  This  treatment  is  completed  by  supplying 
nourishing  gruel  and  food  demanding  little  mastication. 

CATARRHAL    STOMATITIS    IN    SHEEP. 

"  The  more  delicate  buccal  mucosa  in  these  animals  would  render 
them  more  subject  to  inflammations,  but  this  is  more  than  counter- 
balanced by  the  mode  of  prehension  of  aliments,  not  by  the  tongue,  but 
by  the  delicately-sensitive  lips,  and  further  by  the  daintiness  and  care 
with  which  these  animals  select  their  food.  The  treatment  would  not 
differ  materially  from  that  prescribed  for  the  ox."  (Law's  "Veterinary 
Medicine,"  Vol.  II.  p.  15.) 

[The  treatment  referred  to  consists  of  simple  astringent  and  anti- 
septic washes,  borax  given  in  the  drinking  water,  or  mixed  with  honey 
or  treacle  and  smeared  occasionally  on  the  tongue.  Washes  of  sodii 
hyposulphis  or  sulphis,  or  even  weak  solution  of  carbolic  acid,  may  be 
used  after  the  irritant  cause  has  been  removed.  Vinegar  or  diluted 
mineral  acids  may  be  used  alternately  with  decoctions  of  blackberry  bark 
or  other  vegetable  astringents.  When  there  are  symptoms  of  gastric 
disorder  a  laxative,  followed  by  vegetable  bitters  and  other  tonics,  may 
be  prescribed.  Foreign  bodies — thorns,  wire,  etc. — fixed  in  the  tongue, 
cheek,  or  palate  should  be  searched  for  and  removed  at  the  first 
examination  of  the  patient.] 


NECROSING   STOMATITIS    IN   CALVES.  123 


NECROSING    STOMATITIS    IN    CALVeS. 


Definition.  This  name  is  applied  to  a  special  stomatitis,  which  in  very 
young  animals  produces  superficial  necrosis  of  more  or  less  extensive 
areas  of  the  buccal  mucous  membrane,  and  sometimes  of  subjacent  parts. 

The  disease,  although  somewhat  rare  in  France,  has  been  mentioned 
by  Lafosse  and  well  studied  by  Damman  and  Lenglen. 

Causation.  Its  cause  is  still  imperfectly  understood.  Some  regard  it  as 
a  consequence  of  insufficient  nourishment,  of  disturbance  resulting  from 
dentition,  of  general  exhaustion,  and  of  bad  hygienic  conditions.  These 
explanations*  are  scarcely  sufficient,  however,  and  at  the  present  time 
there  is  a  tendency  to  regard  it  as  a  complication  of  primary  grave, 
debilitating  diseases,  like  the  diarrhoea  of  calves,  omphalitis,  omphalo- 
phlebitis, etc.  Moussu  has  never  seen  it  apart  from  omphalitis,  and 
he  considers  the  lesions  due  to  the  action  of  the  bacillus  of  necrosis. 
Infection  occurs  through  the  mnbilicus  becoming  soiled  by  contact  with 
the  litter. 

The  early  symptoms  consist  in  loss  of  aj)petite,  congestion  of  the 
mucous  membranes,  and  salivation.  Early  examination  of  the  buccal 
cavity  reveals  the  presence  everywhere,  except  on  the  palate,  of  whitish- 
grey  or  yellowish  patches,  whose  aspect  is  markedly  in  contrast  with  that 
of  neighbouring  parts.  These  are  fragments  of  the  mucous  membrane 
undergoing  necrosis.  They  are  numerous,  are  surrounded  by  a  narrow 
inflamed  zone,  and  may  be  from  |  inch  to  1  inch  in  diameter. 

Necrosis  advances  rapidly,  and  extends  throughout  the  thickness  of 
the  mucous  membrane  ;  the  slough  soon  becomes  delimited  and  separates. 
The  odour  of  the  mouth  is  then  absolutely  fcetid,  and  the  saliva  appears 
streaked  with  pus  and  blood. 

The  ulcerations  exhibit  a  livid  base,  and  show  no  tendency  to  heal. 
Necrosis  extends  in  depth,  and  affects  the  muscles,  tendons,  and  even  the 
periosteum  and  the  bones.     The  teeth  are  frequently  loosened. 

Grave  complications,  such  as  pharyngitis,  broncho-pneumonia,  infec- 
tious enteritis,  and  septicaemia  soon  appear,  and  the  animals  are  carried 
off  by  septic  infection  and  intoxication  in  a  few  days — at  the  longest 
in  a  week. 

Diagnosis.  The  diagnosis  is  only  difficult  at  first ;  and,  at  a  later 
stage,  the  only  mistake  possible  is  that  of  confounding  the  condition  with 
a  very  grave  attack  of  aphthous  stomatitis.  Local  sanitary  conditions 
are  sufficient  to  secure  the  avoidance  of  this  error. 

Prognosis.  The  prognosis  is  extremely  grave  ;  the  disease  usually 
results  in  death  ;  recovery  is  exceptional.  Very  luckily  the  disease  seems 
to  become  rare  in  direct  proportion  as  the  hygienic  conditions  of  cattle 
breeding  and  keeping  are  improved. 


124  DISEASES  OF   THE   MOUTH. 

Treatment.  Curative  treatment  always  appears  to  be  ineffectual 
when  a  grave  primary  disease  has  already  enfeebled  the  animal  before 
necrosing  stomatitis  appears.  In  those  cases  where  the  stomatitis  con- 
stitutes the  primary  condition,  attempts  should  l)e  made  as  far  as  possible 
to  cleanse  the  wounds.  The  buccal  cavity  should  be  thoroughly  washed 
out,  and  the  wounds  then  cauterised  with  solution  of  carbolic  acid  of 
G  per  cent,  strength,  nitric  acid  of  10  per  cent,  strength,  hydrochloric 
acid  of  7  to  8  per  cent,  strength,  or  chromic  acid  of  20  per  cent, 
strength. 

This  local  cauterisation  is  performed  with  a  tampon  of  cotton  wool 
fixed  to  a  handle ;  for  necessarily  it  is  impossible  to  apply  uny  dressing 
whatever  of  a  permanent  nature.  The  cauterisations  may  be  repeated 
twice  a  day.  The  stump  of  the  umbilical  cord  should  never  be  forgotten, 
for  it  sometimes  contains  a  mass  of  necrotic  tissue  the  size  of  a  man's 
thumb.  It  should  be  thoroughly  cleansed  and  the  wound  plugged  with 
a  mixture  of  iodoform  and  boric  acid. 

This  treatment  will  not  avail  unless  the  functions  are  stimulated  by 
rich  food  that  can  be  easily  masticated  and  digested,  and  by  giving  milk 
of  good  quality,  or  boiled  milk,  eggs,  meat-powder,  cooked  beans,  etc. 
Aromatic  infusions  and  hay  tea  containing  coffee  and  small  quantities 
of  alchohol  or  tincture  of  quinine  are  also  of  service. 


MYCOTIC    STOMATITIS    IN    CALVES. 

Tltrnsh.     Muijuet. 

"This  is  a  form  of  stomatitis  manifested  by  a  raised  white  patch  on  the 
mucous  membrane  and  determined  by  the  presence  of  the  Oidiiim  albicans 
{Sacchavomyces  albicans),  a  cryptogam  discovered  by  Berg  in  18-12  in 
thrush  in  children.  It  is  closely  allied  to  the  vnicor,  and  attacks  only  the 
young  and  feeble.  The  white  crust  consists  of  epithelial  cells  intermingled 
with  an  abundance,  of  the  white  mycelium  and  oval  spores  of  the  fungus. 
Andry  in  his  artificial  cultures  found  that  it  was  pearly  white  when  grown 
on  gelatine,  dirty  white  on  potato,  and  snow  white  on  carrot." 

Symptoms.  "  Buccal  mucosa,  red,  congested  and  tender,  shows  here 
and  there  white  curdy  looking  elevations,  or  red  erosions  caused  by  the 
detachment  of  such  masses.  These  bear  a  strong  resemblance  to  the 
crusts  seen  on  this  mucosa  in  rinderpest,  but  are  easily  distinguished 
by  the  absence  of  the  attendant  fever,  and  by  the  discovery,  under  the 
microscope,  of  the  specific  microphyte.  The  eruption  may  extend  to  the 
pharynx  and  oesophagus  and  interfere  fatally  with  deglutition,  but  usually 
it  merely  renders  sucking  painful  and  is  not  serious." 

Treatment.  Cleanse  and  disinfect  the  sheds,  "  and  invigorate  the  young 
animals  by  sunshine,  free  air  and  exercise.    Locally    .     .    .    borax,  which 


ULCERATIVE    STOMATITIS   IN   SHEEP.  125 

arrests  the  growth  of  the  parasite,  whether  in  artificial  cultures  or  in  the 
mouth.  The  powder  may  be  rubbed  into  the  sores,  or  it  may  be  mixed 
with  .  .  .  molasses  and  used  as  an  electuary.  As  substitutes  boric 
acid,  salol,  thymol,  potash  chlorate,  or  Condy's  fluid  may  be  used." 
(Law's  "Veterinary  Medicine,"  Vol.  II.  p.  3().) 

ULCERATIVE    STOMATITIS    IN    SHEEP. 

The  name  of  ulcerative  stomatitis  of  sheep  has  been  given  to  a  disease 
which  is  characterised  by  the  appearance  of  a  pultaceous  deposit  on  the 
surface  of  the  buccal  mucous  membrane  and  later  by  the  development  of 
ulcerations  and  of  vegetative  growths. 

Causation.  The  cause  is  imperfectly  understood.  In  certain  years 
the  disease  appears  to  attack  lambs  at  the  time  of  weaning,  but  it  may 
also  affect  flocks  of  animals  as  old  as  fifteen  or  eighteen  months,  two 
years,  or  even  more.  It  is  contagious,  and  may  extend  to  one-half  or  two- 
thirds  of  the  entire  number  in  the  flock.  Full-grown  and  old  animals 
appear  to  be  immune. 

It  was  formerly  thought,  a  j^rion,  and  in  consequence  of  the  character 
of  the  buccal  deposit,  that  the  disease  was  identical  with  thrush,  and  that 
the  lesions  were  produced  by  O'ldium  albicans.  Neumann  in  1885  declared, 
however,  that  he  could  not  And  the  fungus  in  question  in  scrapings  from 
the  mucous  membrane. 

Moussu  had  similar  negative  results  in  the  experiments  he  made 
during  1894,  when  he  examined  both  young  and  old  animals  belong- 
ing to  flocks  in  the  departments  of  Berry  and  of  La  Brie. 

In  addition  it  has  been  suggested  that  the  disease  affects  badly  cared- 
for  and  badly  fed  lambs,  and  subjects  suffering  from  "watery  cachexia." 
This  seems  correct  in  many  cases,  and  Moussu  has  seen  ulcerative 
stomatitis  decimate  flocks  which  had  previously  been  attacked  with 
intestinal  helminthiasis  and  verminous  broncho-pneumonia ;  but,  on  the 
other  hand,  in  the  environs  of  Melun  he  saw  it  in  animals  which  had 
previously  been  quite  free  of  disease  and  were  kept  under  perfect  hygienic 
conditions. 

The  conditions  in  which  animals  are  reared,  the  use  of  common  drink- 
ing ponds,  and  the  method  of  supplying  flocks  with  food,  are  the  chief 
causes  of  the  distriljution  of  the  disease. 

Symptoms.  The  symptoms  consist  in  loss  of  appetite,  or  rather  in 
difficulty  in  grasping  and  masticating  food,  wasting,  a  certain  degree  of 
dulness,  and  salivation.  Somewhat  later  one  often  sees  appear  on  the 
free  margin  of  the  upper  and  lower  lips  an  eruption  of  small  vesico- 
pustules,  wdiich  quickly  become  covered  with  yellowish-brown  crusts  and 
bleed  on  the  slightest  touch.  The  lips  swell,  become  sensitive  and  pain- 
ful, so  that  examination  of  the  cavity  of  the  mouth  should  be  made  with 


126  DISEASES   OF   THE    MOUTH. 

care.  The  mucous  membrane  is  then  seen  to  present  a  very  varymg 
number  of  greyish-white  or  greyish-brown  points,  each  of  which  is  due  to 
the  destruction  of  the  epithehum  and  to  the  production  of  a  pultaceous 
deposit,  which  can  very  readily  be  removed,  leaving  uncovered  superficial 
ulcerations,  which  bleed  if  very  lightly  touched.  These  ulcerations  are 
of  irregular  shape,  and  are  distril)uted  most  freely  over  the  gums,  the 
internal  surface  of  the  lips  and  cheeks.  The  palate  and  tongue  are  only 
invaded  in  the  last  stages.  Still  later  one  notes,  instead  of  these  ulcera- 
tions and  as  a  consequence  of  abnormalities  in  the  process  of  repair, 
reddish  violet  turgid  vegetations  varying  in  size  from  that  of  a  millet 
seed  to  that  of  a  pepper-corn  or  even  of  a  small  mulberry. 

The  total  duration  of  the  disease  varies  with  its  degree  of  intensity. 
In  favourable  cases  it  may  not  exceed  eight  to  ten  days ;  in  grave  cases 
it  continues  for  fifteen  to  twenty  days.  Recovery  is  usual  when  the 
subjects  are  vigorous  and  well-nourished  lambs,  or  well-kept  sheep, 
previously  free  of  disease.  On  the  other  hand,  Moussu  has  noted  a  mor- 
tality of  15  to  20  per  cent,  in  thin  animals  of  bad  bodily  condition  and 
already  depressed  by  verminous  broncho-pneumonia  and  intestinal  hel- 
minthiasis. When  the  attack  is  about  to  prove  fatal,  complications  such 
as  gastro-enteritis,  resulting  from  septic  infection  or  intoxication,  and 
accompanied  by  foetid  diarrhcea,  often  make  their  appearance. 

Diagnosis.  The  diagnosis  presents  no  difficulty,  the  characteristics  of 
this  stomatitis  being  entirely  different  from  those  of  the  aphthous  form. 
The  claws  are  never  affected,  and  there  is  no  lameness. 

Prognosis.  In  this  connection  the  practitioner  will  do  wisely  to  avoid 
committing  himself,  and  to  closely  study  the  conditions  under  which  the 
disease  has  developed.  ^In  all  cases  the  appearance  of  foetid  diarrhoea 
must  be  regarded  as  of  very  unfavourable  augury. 

Treatment.  The  first  precaution  to  take  consists  in  separating  all 
the  healthy  animals  in  the  flock,  and  placing  them  in  a  non-contaminated 
spot. 

The  diseased  are  then  treated  one  by  one  ;  each  day  the  buccal  cavity 
is  washed  out  with  boiled  water  or  with  a  solution  of  borax  or  boric  acid. 
After  each  washing  the  ulcerations  should  be  touched  with  tincture  of 
iodine  or  with  some  other  rather  active  antiseptic  solution.  Finally  it 
might  be  useful,  and  would  be  of  value,  to  add  to  the  gruel  or  water  a 
small  quantity  of  common  salt  and  of  salicylate  of  soda  at  the  rate  of 
15  grains  to  the  pint. 

GENERAL    CATARRHAL    STOMATITIS    IN    SWINE. 

Causes.  "  Swine  suffer  from  simple  stomatitis  when  exposed  to 
thermal,  mechanical,  or  chemical  irritants.  Such  irritants  comprise  food 
that  is  too  hot,  or  is  hard  and  fibrous,  or  which  contains  spikes  and  awns, 


GENERAL   CATARRHAL   STOMATITLS   IN    SWINE.  127 

capable  of  entering  and  irritating  gland  ducts  or  sores,  or  food  which  is 
fermented  or  putrid,  food  or  medicine  of  an  irritant  character.  The  habit 
of  catching  and  holding  swine  with  a  running  noose  over  the  upper  jaw, 
and  the  forcing  of  the  jaws  apart  with  a  piece  of  wood  in  search  of  the 
CijsticercHs  ccllulosa  are  further  causes.  In  several  specific  infectious 
diseases  inflammation  of  the  mucous  membrane,  with  eruption  or  erosion, 
is  not  uncommon.  This  aphthous  fever  is  marked  by  vesicular  eruption, 
muguet  b}^  epithelial  proliferation  and  desquamation,  hog  cholera  and 
swine  plague  by  circumscribed  spots  of 'necrosis  and  erosion.  Patches  of 
false  membrane  are  not  unknown,  and  local  anthrax,  tubercle,  and  acti- 
nomycosis are  to  be  met  with.  Inflammation  may  start  from  decaying 
teeth." 

"  Symptoms  resemble  those  in  other  animals,  refusal  of  food,  or  a  dis- 
position to  eat  sparingly,  to  select  soft  or  liquid  aliments,  to  swallow  hard 
materials  half  chewed,  or  to  drop  them,  to  champ  the  jaws,  and  to  seek 
cold  water.  Accumulation  of  froth  around  the  lips  is  often  seen,  and 
the  mouth  is  red,  angry,  dry,  and  hot,  and  exhales  a  bad  odour." 

"  Treatment  does  not  differ  materially  from  that  adopted  in  other 
animals :  Cooling,  astringent,  antiseptic  lotions,  honey  and  vinegar,  and 
in  ease  of  spongy  or  eroded  mucosa,  tincture  of  myrrh  daily  or  oftener. 
Soft  feeding,  gruels,  pulped  roots,  .  .  .  and  clean  water  should  be 
constantly  within  reach.  In  case  of  .  .  .  indigestion  a  laxative, 
followed  by  vegetable  tonics,  will  be  in  order."  (Law's  "Veterinary 
Medicine,"  Vol.  II.  p.  17.) 

ULCERATIVE    STOMATITIS    IN    SWINE. 

"  This  is  the  scorbutus  of  Friedberger  and  Frohner,  the  glossanthrax 
of  Benion." 

Causes.  "  It  has  been  attributed  to  insufficient  or  irritant  food,  to 
damp,  close  pens,  and  to  chronic  debilitating  diseases,  and  all  these 
act  as  predisposing  causes.  In  gastritis  and  in  infectious  fevers  like 
hog  cholera,  swine  plague,  and  rouget  (hog  erysipelas)  the  spots  of  con- 
gestion and  petechias  on  the  buccal  mucous  membrane  may  become  the 
starting  points  for  ulcerative  inflammations.  These  conditions  appear, 
however,  to  be  supplemented  by  infection  from  bacteria  present  in  the 
mouth  or  introduced  in  food  and  water,  and,  as  in  the  case  of  other 
domestic  animals,  the  most  successful  treatment  partakes  largely  of  dis- 
infectant applications." 

Symptoms.  "  Loss  of  appetite,  grinding  of  the  teeth,  champing  of 
the  jaws,  the  formation  of  froth  round  the  lips,  foetor  of  the  breath,  red- 
ness of  the  gums  and  tongue,  and  the  formation  of  vesicles,  or  white 
patches,  which  fall  off,  leaving  red,  angry  sores.  These  may  extend, 
forming  deep  unhealthy  ulcers,  with  increasing   salivation   and  foetor. 


128  DISEASES   OF   THE   MOUTH. 

As  the  disease  advances  the  mitial  duhiess  and  prostration  become  more 
profomid,  and  debiHty  and  emaciation  advance  rapidl.y.  Unless  there  is 
early  improvement  an  infective  pharyngitis  or  enteritis  sets  in,  mani- 
festly determined  by  the  swallowing  of  virulent  matters  from  the 
mouth,  and  swelling,  redness,  and  tenderness  of  the  throat,  or  colics 
and  offensive  black  diarrhoea,  hasten  a  fatal  issue.  Eachitis  may  be 
a  prominent  complication,  as  it  seems  in  some  instances  to  be  a  pre- 
disposing cause." 

Treatment.  "  Isolate  the  healthy  from  the  diseased,  and  apply  dis- 
infection to  all  exposed  articles  and  places.  Employ  local  antiseptics  as 
in  other  animals.  Sulphuric  or  hydrochloric  acids,  in  fifty  times  their 
volume  of  water,  or  tincture  of  iron,  chlorate  of  potash,  or  chloride  of 
ammonia,  or  borax  have  been  used  successfully.  Bitters  and  aromatics 
have  also  been  strongly  recommended,"  (Law's  "  Veterinary  Medicine," 
Vol.  II.  p.  29.) 

MEKCURIAL    STOMATITIS. 

This  form  of  stomatitis  possesses  certain  distinguishing  characters, 
and  develops  after  severe  or  trilling  mercurial  poisoning. 

Causation.  Sheep  sometimes  suffer  from  mercurial  poisoning  as  a 
result  of  the  use  of  baths  containing  corrosive  sublimate  or  mercurial 
ointment  for  acariasis  or  other  cutaneous  parasitism.  Animals  of  the 
bovine  species  seem  predisposed  to  the  disease  as  a  consequence  of  their 
special  sensitiveness  to  the  action  of  mercury,  which  is  not  shared  by 
other  species. 

Mercurial  jjoisoning  may  occur  accidentally,  l)ut  is  usually  the  result 
of  some  attempt  at  treatment.  Any  preparation  containing  mercury  or 
mercurial  salts  may  produce  it.  In  domesticated  animals  it  most  fre- 
quently results  from  the  action  of  the  ordinary  mercurial  blister  or 
mercurial  ointment  of  the  j)harmacopoeia,  or  again  of  calomel.  Sometimes 
it  follows  the  use  of  mercurial  salts  in  uterine  douches,  or  in  lotions  used 
to  wash  out  large  abscess  cavities  or  wounds. 

The  application  of  blisters  or  of  antiparasitic  dressings,  or  infriction 
with  grey  ointment  over  extensive  surfaces,  favours  this  intoxication.  It 
may  result  from  direct  local  intra-cutaneous  absorption,  from  vapour  given 
oft'  by  mercurial  applications  obtaining  entrance  into  the  body  through 
the  broncho-pulmonary  and  digestive  tracts,  from  vapour  given  oft"  by 
metallic  mercury  (as  in  ships'  holds),  or  from  ingestion  of  mercurial 
compounds  licked  off  the  skin,  as  certainly  occurs.  Hitherto  in  all  dis- 
cussions, even  the  most  recent,  on  the  mechanism  of  poisoning,  partisans 
of  different  views  do  not  appear  to  have  given  sufficient  attention  to  these 
now  clearly  proved  facts.  The  conclusion  to  be  drawn  is  that  in  animals  of 
the  bovine  species  mercurial  preparations  ought  to  be  used  with  caution. 


MERCURIAL    STOMATITIS.  129 

and  that  even  under  sacli  conditions  stomatitis  may  appear.  Finally,  it 
should  be  remembered  that  all  lesions  of  the  kidney  indicated  by  albumi- 
nuria and  other  signs,  and  all  lesions  of  the  liver,  favour  poisoning  by 
checking  or  preventing  the  elimination  of  mercury  by  the  kidney,  or  by 
interfering  with  its  transformation  in  the  hepatic  cells. 

Nature.  Eegarding  the  essential  nature  of  stomatitis,  it  would  appear 
(according  to  the  work  carried  out  in  1890  by  Gallipe  on  mercurial  stoma- 
titis in  mail),  that  we  should  regard  it  as  a  septic  stomatitis,  and  not  as  a 
primary  toxic  stomatitis.  The  mercury  absorbed  by  the  body  not  only 
produces  salivation,  but  a  very  important  change  in  the  chemical  compo- 
sition of  the  saliva.  The  vitality  and  toxicity  of  the  saprophytic  microbes 
normally  present  in  the  buccal  cavity  appear  gfeatly  to  increase,  and 
although  only  the  most  trilling  erosions  may  exist  in  the  mucous  mem- 
brane, true  intra-mucous  inoculation  takes  place,  and  forms  the  point  of 
origin  for  septic  stomatitis. 

It  has  been  found  that  it  is  not  even  necessary  to  have  lesions  in  the 
buccal  mucous  membrane  ;  in  fact,  this  is  the  weak  point  in  the  theory 
emitted.  Nor  is  a  modification  in  the  chemical  composition  of  the  saliva 
sufficient ;  for  when  a  mixture  of  iodine  and  the  iodides,  for  example,  is 
being  given,  the  saliva  is  chemically  modified,  and  yet  stomatitis,  properly 
so-called,  does  not  occur. 

What  seems  most  probable  is  that  mercurial  stomatitis  is  a  toxi- 
infectious  stomatitis,  in  the  development  of  which  mercury  acts  primarily 
by  its  toxic  effect  on  the  salivary  glands,  whose  secretion  it  modifies,  and 
on  the  l)uccal  epithelium,  the  renewal  of  which  it  checks.  Infection  of 
the  mucous  membrane  is  thereby  favoured,  even  in  the  absence  of  any 
previous  lesion,  and  stomatitis  develops. 

Symptoms.  The  symptoms  consist  in  abundant  salivation  with 
discharge  from  the  mouth,  suggesting  the  existence  of  foot-and-mouth 
disease.  In  grave  cases  the  saliva  appears  streaked  with  blood,  even 
from  the  beginning.  The  buccal  cavity  exhales  an  intense  foetid  odour 
which,  during  the  following  days,  becomes  more  marked ;  the  mucous 
membrane  is  pale  in  colour,  and  coated  with  a  greyish  exudate.  The 
mouth  is  hot  and  sensitive,  the  gums  are  swollen,  reddish-violet  in 
colour,  and  painful.  Alveolar  periostitis  soon  sets  in,  the  teeth  become 
loose,  and  mastication  is  rendered  impossible,  especially  as  the  inflam- 
mation causes  the  tongue  to  swell  and  lose  its  mobility.  These 
symptoms  are  unaccompanied  by  fever. 

In  the  last  stage  ulcerations  and  local  necroses  appear  on  the  gums, 
on  the  inner  surface  of  the  lips  and  cheeks,  and  around  the  commissures 
of  the  lips.  The  patients  are  almost  unable  to  feed,  rapidly  lose  flesh, 
become  anaemic,  and  die  from  septic  infection.  The  temperature  is  often 
below  normal. 

D.C.  K 


130  DISEASES   OF   THE    MOUTH. 

A  toxi-infectious  gastro-enteritis,  with  foetid,  blood-stained  diarrhoea, 
is  grafted  on  the  primary  stomatitis.  CompHcations  in  connection 
^yith  the  respiratory,  circulatory,  and  urinary  apparatus  appear,  and 
the  patients  die  in  a  condition  of  absolute  exhaustion. 

Naturally  this  termination  is  not  inevitable  ;  trifling  cases  of  poisoning, 
and  even  grave  forms,  when  properly  treated,  may,  and  should,  recover. 

Diagnosis.  The  diagnosis  is  mainly  based  on  the  history,  except  in 
cases  of  accidental  and  unsuspected  poisoning. 

Prognosis.  The  prognosis  is  grave,  for  even  when  the  disease  does 
not  prove  fatal  the  animals  remain  anai-mic  and  exhausted  for  long 
periods. 

Treatment  should  principally  be  directed  towards  combatting  the 
local  comjilications.  When  poisoning  is  due  to  external  applications 
of  mercury  or  its  salts  the  skin  should  be  washed  with  soap  and  water, 
and  afterwards  dressed  with  a  soluble  sulphide,  which  renders  the  mer- 
cury insoluble.  The  mouth  should  frequently  be  rinsed  with  boiled  water, 
with  decoctions  of  barley  or  marsh-mallow,  with  a  30  per  cent,  solution  of 
boric  acid  or  alum,  or  with  a  1  to  2  per  cent,  solution  of  salicylic  acid. 

Fully  grown  cattle  receive  daily  doses  of  1:|-  to  2  drams  of  chlorate 
of  potash  internally.  This  drug  appears  to  owe  its  favourable  action 
to  the  fact  that  it  is  partly  eliminated  by  the  salivary  glands.  Lastly, 
with  the  idea  (which  may,  perhaps,  be  illusory)  of  minimising  and 
checking  the  liad  effects  of  the  mercury  introduced  into  the  body,  certain 
jDractitioners  have  recommended  the  administration  of  eggs,  flowers  of 
sulphur  (2 J  to  5  drams),  sulphate  of  iron  (1^  to  2 J  drams),  and  of  iodide 
of  potassium  (1^  to  2^  drams),  drugs  which  are  alleged  to  form  insoluble 
compounds  with  mercury. 

GLOSSITIS. 

The  term  "  glossitis  "  is  applied  to  all  inflammations  of  the  tongue, 
whether  superficial  or  deep  seated.  These  inflammations  may  result 
from  trifling  causes,  in  which  case  they  are  termed  "  simple,  acute, 
or  chronic  golossites " ;  or,  on  the  other  hand,  from  well-recognised 
causes,  like  tuberculosis  or  actinomycosis,  in  which  case  they  receive 
the  name  of  "  specific  glossites."  Here  only  ordinary  glossites  are 
investigated,  the  others  being  more  particularly  described  in  chapters 
specially  reserved  for  the  description  of  the  primary  diseases  of  which 
these  form  symptoms. 

SUPERFICIAL    GLOSSITIS. 

This  condition  is  characterised  by  lesions  in  the  mucous  membrane 
or  in  the  immediately  subjacent  tissues,  deeper  seated  structures  not 
being  involved. 


ACUTE    DEEP-SEATED    GLOSSITIS.  131 

The  causes  are  similar  to  those  of  simple  stomatitis,  and  as  in  animals 
of  the  bovine  species  the  tongue  is  the  principal  and  almost  the  only 
organ  of  prehension,  it  is  particularly  exposed  to  the  chance  of  injury. 

As  mechanical  injury  done  by  rough  fodder  first  makes  its  effects 
felt  on  the  tongue,  superficial  glossitis  is  often  due  to  the  action  of  sharp 
or  prickly  plants  like  fnrze,  wrest-harrow,  thistles,  sea-holly,  etc.  The 
glumes,  awns,  and  spikelets  on  certain  plants  play  a  similar  part. 

Caustic  medicinal  draughts,  hot  drinks,  and  sharp  points  on  the 
molar  teeth  may  also  produce  the  disease  without  the  rest  of  the  buccal 
mucous  membrane  being  involved. 

Symptoms.  These  are  extremely  simple.  There  is,  first  of  all,  some 
difficulty  in  grasping  the  food  and  some  diminution  of  appetite,  which, 
however,  is  more  apparent  than  real,  the  digestive  organs  acting  well. 
The  second  symptom  consists  in  moderate  salivation  without  special 
characters. 

The  local  symptoms  alone  are  characteristic.  The  mucous  membrane 
covering  the  tongue  appears  red,  swollen,  locally  inflamed,  and  painful. 
The  inflamed  areas  are  usually  located  on  the  free  part  near  the  frsenum 
or  opposite  the  molar  teeth. 

Thorns,  foreign  bodies,  awns  or  spikelets  of  rough  grasses  can  often 
be  seen  implanted  in  the  tongue,  and  if  the  disease  has  existed  for  a 
short  time,  little  ulcerations  may  not  improbably  be  discovered. 

Diagnosis.  The  characteristics  of  this  superficial  glossitis  are  suffi- 
ciently marked  to  allow  of  easy  diagnosis,  and  to  prevent  it  being 
confused  with  the  lesions  of  actinomycosis  or  tuberculosis  or  with  the 
extensive  desquamation  which  accompanies  foot-and-mouth  disease. 

Prognosis.  The  prognosis  is  never  grave.  Recovery  occurs  in  six 
to  eight  days,  provided  the  primary  cause  be  removed. 

Treatment  consists  in  avoiding  the  use  of  rough  food,  in  removing 
foreign  bodies  implanted  in  the  mucous  membrane  or  in  rasping  rough 
and  irregular  teeth.  For  the  rest,  as  in  stomatitis,  mere  attention  to 
cleanliness  suffices.  The  mouth  is  washed  out  with  boiled  water,  boric 
acid  solution,  mixtures  of  vinegar  and  water,  or  with  water  containing  a 
small  percentage  of  alcohol. 


ACUTE    DEEP-SEATED    GLOSSITIS. 

This  disease  has  also  been  termed  parenchymatous  and  interstitial 
glossitis,  because  all  the  deep-seated  tissues,  including  the  muscles  and 
connective  tissue  layers  are  involved  in  the  inflammation. 

Causes.  The  disease  may  be  due  to  a  neglected  attack  of  super- 
ficial glossitis,  to  some  grave  microbic  infection,  or  to  excoriation  and 
ulceration  of   the  mucous  membrane.      Very  often  it   is  of   traumatic 

K  2 


132  DISEASES   OF   THE   MOUTH. 

origin,  aiul  is  due  to  violent  traction  on  the  tongue  by  herdsmen  or 
othei's  when  administering  draughts  of  their  own  composition.  This 
traction  causes  rupture  of  the  muscle  and  slight  interstitial  hemorrhage. 

The  symptoms  develop  somewhat  rapidly.  Whilst  at  first  the  animal 
shows  difficulty  in  grasping  food,  it  is  soon  totally  incapable  of  doing  so. 
The  tongue  loses  its  mobility,  is  no  longer  protruded  from  the  mouth,  and 
swallowing  becomes  so  painful  that  salivation  sets  in.  On  direct  exami- 
nation the  tongue  is  found  swollen,  thickened,  immobile,  painful,  and 
occupying  the  whole  of  the  oral  cavity,  sometimes  projecting  beyond  the 
region  of  the  incisors,  and  preventing  the  mouth  being  closed.  Inflam- 
mation may  become  so  intense  that  the  point  of  the  tongue  hangs  out  of 
the  mouth.  It  becomes  blackish,  bleeding,  swollen,  and  excoriated  by 
contact  with  foreign  bodies  or  simj)ly  with  the  row  of  incisor  teeth. 
The  saliva  becomes  foetid,  blood-stained  and  purulent,  and  contains  large 
quantities  of  broken  down  epithelial  cells.  It  is  not  uncommon  to  note 
more  or  less  extensive  necrosis. 

Diagnosis.  The  diagnosis  of  this  form  of  glossitis  presents  no 
difficulty,  for  if  under  certain  conditions  it  may  resemble,  for  example, 
the  glossitis  of  actinomycosis,  it  differs  essentially  from  that  disease  by 
its  rapidity  of  development,  by  its  complications,  and  also  by  the  absence 
of  the  specific  ray  fungus. 

Prognosis.  The  prognosis  is  grave,  not  only  on  account  of  the 
possible  complications,  but  also  because  the  animals  are  unable  to  feed 
and  therefore  lose  flesh  with  very  great  rapidity. 

Treatment.  The  first  steps  in  treatment  are  in  the  nature  of  local 
disinfection,  in  order  to  prevent  general  infection.  The  mouth  therefore 
should  be  washed  out  five  or  six  times  per  day  with  boiled  water,  followed 
by  antiseptic  injections  until  improvement  commences.  Solutions  of 
boric  acid  or  l)orax  (8  per  cent.),  chlorate  of  potassium  (2  to  3  per  cent.), 
or  salicylic  acid  (3  to  4  per  cent.),  are  useful,  but  the  free  employment  of 
1,  2,  or  3  per  cent,  solutions  of  chloral  is  even  preferable. 

With  the  idea  of  protecting  the  organ  from  external  injury,  Lafosse 
formerly  suggested  the  use  of  a  suspensory  bandage  for  the  tongue,  fixed 
to  the  base  of  the  horns  by  small  bandages.  Guittard  recommends 
scarification  of  the  free  part,  and  the  application  of  a  support  perforated 
at  the  bottom  to  allows  the  blood,  saliva,  pus,  etc.,  to  escape.  In  spite  of 
careful  attention  the  disease  may  last  from  two  to  three  weeks. 


CHRONIC    GLOSSITIS. 

This  form  of  disease  has  also  ))een  termed  "  sclerosing  glossitis  "  and 
"  non-actinomycotic  wooden  tongue,"  because  it  is  anatomically  charac- 
terised by  induration  of  the  tissues,  and  because  apparently  it  resembles 


CHRONIC    GLOSSITIS,  133 

true  "wooden  tongue,"  with  which  it  was  confused  until  within  the  last 
few  years.  Imminger  in  1888  and  Pflug  in  1891  descrihed  two  forms. 
The  first,  termed  "  superficial  sclerosing  glossitis,"  is  said  to  be  the 
more  frequent,  and  most  commonly  affects  young  animals  suffering  from 
irregularities  in  dentition.  It  seems  due  to  a  superficial  acute  glossitis 
assuming  a  chronic  form.  The  submucous  connective  tissue  in  time 
undergoes  hyperplastic  changes,  so  that  the  tongue  at  first  becomes 
swollen  and  afterwards  absolutely  rigid.  One  never  finds  ulcerations  or 
actinomyces. 

Diagnosis.  A  close  examination  will  always  enable  the  case  to  be 
diagnosed  at  the  first  visit,  or  under  any  circumstances  after  a  short 
time. 

The  prognosis  is  very  grave,  because  the  animal  has  the  greatest 
difficulty  in  grasping  and  masticating  food,  or  may  even  be  unable  to  do 
so.     Patients  lose  flesh  very  rapidly,  and  end  by  dying  of  hunger. 

Treatment  is  of  little  service.  The  administration  of  iodine,  the 
only  drug  which  appears  indicated,  has  proved  of  very  questionable 
value.     Economically,  it  is  better  to  slaughter  the  animal. 


The  second  variety  is  rare,  and  has  been  termed  "  deep-seated 
sclerosing  glossitis."  It  is  simply  a  chronic  form  of  ordinary  deep- 
seated  glossitis.  The  layers  of  connective  tissue  sei)arating  the  muscles 
are  reju'esented  by  very  hard,  inelastic  vertical  partitions.  As  a  con- 
sequence, the  whole  tongue  becomes  indurated  and  more  or  less  com- 
pletely immobile.  In  this  condition,  again,  there  is  neither  ulceration 
nor  actinomyces. 

Diagnosis.  The  diagnosis  necessitates  a  careful  examination.  In 
the  living  animal  it  is  very  difficult  to  establish  a  distinction  between 
this  and  the  preceding  form,  though  after  death  the  task  becomes  much 
easier.  • 

The  prognosis  is  grave,  complete  restoration  of  the  parts  being 
impossible. 

The  treatment  differs  in  no  respect  from  that  given  in  the  preceding 
instance.     It  is  of  little  value. 


Imminger  and  Pflug  have  also  described  a  deep-seated  nodular  scleros- 
ing glossitis,  characterised  anatomically  by  the  existence  in  the  depth  of 
the  tongue  of  fibrous  nodules,  varying  in  size  between  a  small  nut  and 
a  fowl's  egg.      The  tongue  is  only  slightly  increased  in  size. 

This  disease  may  perhaps  be  due  to  actinomycosis. 


CHAPTER    II. 

DISEASES    OF    THE    SALIVARY    GLANDS,    TONSILS 
AND    PHARYNX. 

PAROTIDITIS    (PAROTITIS). 

The  term  "  parotiditis  '"  indicates  an  intlammatory  condition  of  the 
parotid  gland.  Of  this  disease  several  forms  exist.  The  disease  is  termed 
simple  when  due  to  accidental  causes  or  infections,  specific  when  result- 
ing from  some  special  disease  germ  like  the  ray  fungus.  Anatomically, 
these  diseases  consist  in  inflammation  of  the  glandular  parenchyma  and 
connective  tissue  stroma  which  surrounds  the  acini. 

ACUTE    PAROTIDITIS. 

Causation.  The  causes  of  acute  parotiditis  are  varied.  Mechanical 
violence  or  contusions  (due  to  collisions  with  fixed  bodies,  horn  thrusts, 
or  hlows  from  the  ox-goad)  may  produce  it,  the  glandular  parenchyma 
and  connective  tissue  separating  the  acini  or  the  peri-glandular  tissue 
being  torn,  crushed,  lacerated,  and  often  also  directly  infected  in  conse- 
quence of  the  injury.  Ascending  infection  through  the  medium  of  the 
salivary  ducts  represents  a  second  possible  cause  of  the  disease. 

Finally,  parotiditis  may,  in  some  cases,  constitute  only  a  localisation 
of  a  general  disease.  It  seems  a  fact  that  in  rare  circumstances  paro- 
tiditis may  assume  an  epizootic  character,  and  attack  a  large  number  of 
animals  in  a  particular  stable  or  in  neighbouring  stables  ;  and  if,  under 
these  circumstances,  we  are  unable  to  blame  the  food  (which  has  not  been 
done),  we  are  forced  to  admit  the  influence  of  infection  and  contagion. 

Symptoms.  Whatever  the  cause,  the  symptoms  are  generally  well 
marked.  In  many  cases  the  first  indication  of  the  disease  is  apparent 
or  real  want  of  appetite,  always  complicated  with  difficulty  in  swallowing, 
and  often  accompanied  by  trifling  fever. 

Salivation,  resulting  from  irritation  of  the  gland  and  inability  to 
swallow,  becomes  abundant,  and  at  once  draws  attention  to  the  buccal 
cavity  and  adjacent  parts.  Inspection  of  the  patient  then  reveals  the 
existence  in  the  parotid  region  of  a  diffuse  swelling,  which  on  palpa- 
tion is  found    to    be  hot    and   painful,   and  to   occupy    the    whole    of 


ACUTE    PAROTIDITIS. 


135 


tii 


the  parotid  region  between  the  lower  jaw  and  the  upper  extremity  of 
the  neck.     The  lesion  is  usually  unilateral,  but  occasionally  bilateral. 

Parotiditis  may  terminate  in  resolution,  suppuration,  or  necrosis. 
The  suppuration  may  either  be  simply  subcutaneous  and  extra-glan- 
dular, or  may  involve  a  portion  of  the  salivary  gland  and  of  the  parotid 
lymphatic  gland  in  addition. 

Necrosis  is  exceptional,  though  Moussu  saw  double  and  total  gangrene 
of  both  parotids,  complicated  with  septicaemia,  in  the  animal,  of  which  a 
sketch  is  given  herewith. 

If  the  disease  is  due  to  violent  injury  by  a  foreign  body,  traces  of  a 
wound  may  be  found,  but  it 
is  often  useless  to  search  for 
these,  even  when  the  parts 
have  been  pricked  with  a 
sharp  goad.  When  the  in- 
flammation has  resulted  from 
ascending  infection  of  the 
salivary  ducts,  exaggerated 
sensibility  may  sometimes 
be  detected  throughout  the 
whole  length  of  Stenon's 
duct,  particularly  at  the  point 
where  the  duct  crosses  the 
jaw.  There  is  always  marked 
difficulty  in  moving  the  head, 
particularly  towards  the  side, 
and  sometimes  in  a  vertical 
plane.  The  head  is  extended 
on  the  neck,  and  is  held  stiffly 
in  such  a  way  as  to  suggest 

the  possibility  of  tetanus.  Some  observers  have  described  as  an  impor- 
tant symptom  marked  swelling  of  the  orifice  of  Stenon's  duct.  It  is  cer- 
tainly difficult  to  detect,  and  furthermore  is  of  no  great  significance. 

Diagnosis.  Although  diagnosis  is  easy,  it  is  a  difficult  matter  to 
detect  the  point  of  origin  of  the  disease.  The  salivation  and  difficulty 
in  swallowing  might  seem  to  suggest  pharyngitis,  a  condition  which 
sometimes  exists  simultaneously.  The  distinction  between  this  disease 
and  the  forms  of  chronic  parotiditis,  or  tumour  formation  in  the  parotid 
(due  to  actinomycosis,  lymphadenoma,  melanoma),  is  also  easy,  on  ac- 
count of  the  slow  development  of  the  last-named  conditions.  The  only 
condition  liable  to  be  confused  with  that  under  consideration  is  abscess 
of  the  sub-parotid  gland. 

Prognosis.     The    gravity   of    the    disease   varies    greatly.       When 


Fig.  63. — Acute  parotiditis. 


13G       DISEASES    OF    THE    SALIVARY    GLANDS,    TONSILS    AND    PHARYNX. 

inflammation  is  slight,  resolution  usually  occurs  in  eight  to  fifteen  days. 
The  onset  of  suppuration  is  announced  hy  renewal  of  the  fever,  by  more 
marked  swelling,  which  becomes  localised  at  a  given  point,  and  by  the 
existence  of  deep  or  superficial  fluctuation.  Care,  however,  is  required 
to  detect  the  last  named. 

Necrosis  may  occur  suddenly  when  the  infecting  organism  is  specially 
virulent,  and  may  afi"ect  one-third,  one-half,  or  the  whole  of  the  gland. 
The  prognosis  then  becomes  extremely  grave,  and  if  diagnosis  has  not 
been  prompt  and  treatment  energetic,  death  may  follow  in  a  short  time 
from  septic  infection. 

Treatment.  Unless  some  well-marked  sign  foreshadows  a  compli- 
cation, treatment  should  be  directed  to  ensuring  resolution.  Bleeding 
has  been  recommended  ;  its  good  effects,  however,  are  open  to  doubt, 
though  one  cannot  entirely  forbid  it.  All  practitioners  agree  in  recog- 
nising the  value  of  vesicant  applications.  The  afi'ected  parts  may  be 
freely  dressed  with  an  ointment  containing  2  per  cent,  each  of  pulverised 
tartar  emetic  and  bichromate  of  potash,  with  the  ordinary  cantharides 
blister,  or  even  with  a  weak  mercurial  blister,  provided  that  the  animals 
can  be  prevented  from  licking  the  wound. 

Some  practitioners  prefer  vesicants  prepared  with  cantharides  and 
croton  oil.  Whatever  be  the  vesicant  chosen,  it  is  best  after  three  or 
four  days  to  apply  emollients  of  slightly  antiseptic  character,  such  as 
ointments  containing  camphor,  boric  acid,  salol,  etc.  When  abscess 
formation  is  recognised  the  abscess  should  be  opened  as  early  as  possible. 
Some  precautions  are  necessary  to  avoid  injuring  important  nerves  and 
vessels ;  in  dealing  with  a  deep-seated  abscess  it  is  necessary  to  use  the 
knife  for  dividing  the  skin  alone,  to  seek  the  abscess  by  blunt  dissection 
wdth  the  finger  or  with  round-pointed  scissors,  and  to  open  it  with  a 
similar  instrument.  The  cavity  should  then  be  freely  washed  out  with  a 
warm  antiseptic  solution — 3  per  cent,  carbolic  solution,  or  1  per  cent, 
iodine  solution,  etc.  If  necessary  a  drain  composed  of  iodoform  gauze 
can  be  inserted,  or  a  counter-opening  made. 

In  the  case  of  partial  necrosis,  all  the  necrotic  tissue  must  be  carefully 
removed,  injury  to  vessels,  which  would  favour  septicfemic  infection,  being 
avoided.  Afterwards  free  antiseptic  irrigation  should  be  employed  several 
times  per  day. 

In  necrosis  of  the  entire  parotid  extirpation  may  seem  indicated ;  but 
the  greatest  prudence  is  demanded,  for  the  operation  is  extremely  serious 
and  delicate. 

CHRONIC    PAROTIDITIS — PAROTID    FISTULA. 

When  a  case  of  acute  parotiditis  is  not  treated,  and  does  not  end 
in  suppuration,  it  is  usually  succeeded  l)y  chronic  inflammation  and  fibrous 


INFLAMMATION    OF    THE    SUBMAXILLARY    GLAND.  187 

induration  of  the  gland.  Any  obstruction  of  Stenon's  duct,  whatever  the 
originating  cause  (foreign  bodies  Hke  wheat  awns,  oat  grains,  calculi,  etc.) 
stops  the  flow  of  saliva  throughout  the  excretory  apparatus,  and  produces 
over  the  entire  parotid  region  a  doughy  swelling,  which  might  seem  to 
indicate  the  existence  of  indolent  parotiditis.  The  collections  of  liquid 
thus  produced  have  improperly  been  termed  "  salivary  abscesses."  If 
ascending  infection  fails  to  occur,  or  if  infection  is  unimportant  and  does 
not  lead  to  suppuration,  a  relatively  painless  chronic  parotiditis  develops, 
and  in  this  case  movements  of  the  head  and  mastication  and  deglutition 
alone  are  impeded. 

The  salivary  ducts,  however,  may  l)ecome  so  distended  that  the  main 
superficial  collecting  duct  undergoes  softening,  and  the  sldn  covering  it 
becomes  ulcerated,  just  as  would  occur  had  a  true  abscess  formed. 
Under  such  circumstances  the  sldn  soon  jdelds  and  a  salivary  fistula  is 
estal)lished. 

The  symptoms  consist  in  swelling  or  induration  of  the  gland,  inter- 
ference with  movement  of  the  head  and  with  mastication ;  the  whole 
developing  slowly  without  pain  or  fever. 

The  distinction  of  this  condition  from  actinomycosis  of  the  parotid 
may  sometimes  present  some  difficulty  until  a  fistula  develops. 

The  prognosis  is  grave,  because  there  is  no  hope  of  normal  condi- 
tions being  restored. 

Treatment.  Treatment  often  proves  unsuccessful.  Should  the 
condition  have  resulted  from  an  obstruction,  it  is  first  necessary  to 
attempt  the  removal  of  such  obstruction,  whether  it  be  a  foreign  body 
or  calculus,  and  so  to  re-establish  the  normal  channel  for  the  saliva. 
Local  stimulation  may  be  tried,  though  in  cases  of  fistula  without  much 
hope  of  success.  Smart  blistering  of  the  parts  surrounding  the  opening 
and  firing  in  points  have  been  recommended ;  but  rather  than  persist  in 
prolonged  treatment  of  doubtful  value,  it  is  often  better  to  prepare  the 
animals  for  slaughter. 


INFLAMMATION    OF    THE    SUBMAXILLARY   SALIVARY    GLAND. 

Inflammation  of  the  submaxillary  gland  is  rare  in  the  ox.  As  in  the 
horse,  it  is  usually  caused  by  the  penetration  of  foreign  bodies,  such  as 
glumes  or  awns  of  grain,  fragments  of  straw,  thorns,  etc.,  into  Wharton's 
duct. 

The  difficulty  in  grasping  food  and  the  restricted  movement  of  the 
tongue  are  the  first  symptoms  to  attract  attention.  On  examination, 
the- region  of  the  "  barbs,"  usually  on  one  side,  appears  injected,  swollen, 
inflamed,  and  sensitive. 

The  submaxillary  space  is  effaced  by  the  swelling  of  Wharton's  duct; 


188      DISEASES    OF   THK    SALIVARY    GLANDS,    TONSILS    AND    PHARYNX. 

the  corresponding  sul)niaxillary  gland  is  doughy  and  painful  on  pres- 
sure.    The  symptoms  rarely  heeome  more  threatening  than  this. 

The  diagnosis  presents  no  difficulty. 

The  prognosis  is  favourahle. 

Treatment  consists  primarily  in  removing  the  obstruction  from  the 
duct.  Steady  pressure  from  behind,  forwards  along  the  course  of  the 
duct,  may  sometimes  cause  the  foreign  body  to  be  ejected  into  the  mouth, 
along  with  a  jet  of  offensive  saliva.  The  distended  and  inflamed  duct 
soon  becomes  emptied,  and  all  the  symptoms  rapidly  diminish.  In  other 
cases,  when  the  obstructing  body  is  firmly  fixed  in  position,  it  is  necessary 
to  open  the  duct  within  the  mouth  by  a  stroke  of  the  bistoury. 

TONSILITIS    IN    PIGS. 

"  Acute  and  chronic  forms  are  seen.  The  former  has  the  general 
causes  and  symptoms  of  pharyngitis — fever,  duhiess,  a  disposition  to  lie 
with  head  extended  and  buried  in  litter,  drooping  ears,  watery  eyes, 
indifferent  appetite,  painful  deglutition,  and  sometimes  vomiting.  Mouth 
red  and  hot,  breath  foetid,  tonsils  swollen,  their  alveoli  filled  with  muco- 
purulent matter  or  with  foetid  cheese-like  masses.  Cough  at  first  dry 
and  hard,  later  loose  and  gurgling. 

In  chronic  form  there  is  general  swelling  of  the  tonsils  with 
distension  of  follicles  by  above-mentioned  putty-like  masses,  which  are 
often  calcareous.  These  are  due  to  the  proliferation  of  microbes,  which 
find  in  these  alveoli  a  most  favourable  field  for  their  propagation.  The 
affection  usually  ends  in  recovery,  but  may  go  on  to  grave  local  ulceration 
and  general  infection. 

Treatment.  Astringent  antiseptics  to  buccal  mucous  membrane. 
Electuaries  of  honey  or  treacle  and  borax,  sal  ammoniac,  chlorate  or 
permanganate  of  potash  and  externally  stimulating  embrocations  to  the 
skin  of  the  throat.  In  some  cases  solutions  of  iron  chloride  or  tinc- 
ture of  iodine  may  be  used  with  advantage  and  as  a  wash  for  the  mouth 
and  fauces.  Attend  to  general  health.  If  constipated  give  Glauber's 
salt  or  jalap,  .  .  .  and  elimination  through  the  kidneys  must  be 
sought  through  the  use  of  nitrate  of  potash  or  other  diuretic."  (Law's 
"  Veterinary  Medicine,"  Vol.  II.  p.  46.) 

PHARYNGITIS. 

Inflammation  of  the  mucous  membrane  of  the  pharynx  is  less  frequent 
in  the  ox  than  in  the  horse,  a  fact  probably  due  to  its  less  sensitive 
character  in  the  ox  and  to  differences  in  the  methods  of  working  oxen. 

Causation.  The  causes  are  numerous  and  varied  ;  and  although 
local  microbic  infection  undoubtedly  plays  the  most  effective  part  in  the 
development  of  the  disease,  it  is  none  the  less  certain   that  external 


PHARYNGITIS.  139 

influences  are  of  considerable  importance.  For  this  reason  chills, 
sudden  variations  in  temperature,  sudden  arrest  of  perspiration,  and 
currents  of  cold  air  have  always  been  invoked  as  causes.  Cruzel  thinks 
that  the  ingestion  of  ice-cold  water  in  winter  is  sufficient  to  produce 
acute  pharyngitis.  The  action  of  rough  forage  may  of  itself  explain  the 
development  of  pharyngitis  in  animals  constantly  kept  indoors  under 
excellent  hygienic  conditions.  In  such  cases  the  disease  may  be  regarded 
as  of  traumatic  origin.  Furthermore,  it  is  necessary  to  mention  direct 
injuries  of  the  mucous  membrane  caused  by  clumsy-  examination, 
awkwardness  in  passing  the  probang,  and  attempts  on  the  animal's  part 
to  swallow  sharp  foreign  bodies,  which  scratch,  tear,  lacerate,  or 
l^enetrate  the  mucous  membrane  and  become  fixed  in  it. 

Finally,  another  series  of  causes,  and  not  the  least  important, 
remains  to  be  considered — viz.,  the  forced  administration  of  irritant 
substances  like  ammonia,  tincture  of  iodine,  oil  of  turpentine,  very  hot 
liquids,  etc. 

To  sum  up,  the  four  great  series  of  causes  consist  in  direct  irritation, 
intra-pharyngeal  wounds,  variations  in  temperature,  or  primary  or 
secondary  microbic  infections. 

The  symptoms  are  characteristic.  They  consist  in  loss  of  ajipetite, 
difficulty  in  swallowing,  consequent  on  the  condition  of  the  pharynx,  and 
fever,  which  is  often  marked  from  the  first.  Pharyngeal  dysphagia  can 
easily  be  distinguished  from  that  due  to  injury  of  the  oesophagus, 
inasmuch  as  it  occurs  on  the  first  attempt  to  swallow. 

Urged  on  by  hunger,  the  animal  grasps  food,  which  it  chews  and 
attempts  to  swallow,  but  immediately  allows  it  to  fall  back  into  the 
manger,  or  ejects  it  by  a  painful  coughing  effort.  In  the  case  of  liquids, 
even  of  lukewarm  drinks,  the  same  accident  occurs,  the  food  or  liquid  being 
returned  by  the  nostrils.  Slight  salivation  results  from  this  difficulty  in 
swallowing.  The  animal's  attitude  is  similar  to  that  in  parotiditis.  The 
head  is  held  stiffly,  extended  on  the  neck,  in  order  to  avoid  compressing 
the  region  of  the  pharynx,  and  can  only  be  moved  slowly  and  with  much 
pain.  There  is  no  apparent  swelling  of  the  parotid  region,  but  on 
manipulating  or  pressing  on  the  gullet  the  animal  sometimes  manifests 
the  very  acute  tenderness  of  the  parts  by  coughing  and  endeavouring  to 
thrust  away  or  to  kick  the  examiner.  Finally,  examination  of  the  mouth 
sometimes  shows  reddening  and  excessive  sensibility  of  the  soft  palate 
and  of  the  pillars  of  the  fauces. 

These  symptoms  often  assume  a  more  alarming  character,  or  are  com- 
plicated by  others  ;  in  fact,  the  condition  very  rarely  stops  at  pharyngitis, 
but  is  usually  accompanied  by  inflammation  of  the  larynx,  of  the  soft 
palate,  and  of  the  naso-pharynx.  The  whole  throat  is  then  inflamed ; 
the   nose  and  sometimes  the  eyes  discharge,  and  there  is  difficulty  in 


140      DISEASES   OF   THE   SALIVARY    GLANDS,    TONSILS  AND    PHARYNX. 

swallowiii<:;",  interference  with  respiration  or  noisy  respiration,  and  intense 
fever. 

Diagnosis.  The  diagnosis  presents  no  difficult^',  the  s_ymptoms  men- 
tioned l)eing  easy  to  identify,  whether  the  condition  be  simply  inflam- 
mation  of  the  pharynx  or  be  of  a  more  extensive  character.  Never- 
theless, cases  occur  where  the  symptoms  are  alarming,  but  in  which 
one  might  hesitate  between  the  diagnosis  of  ordinary  acute  sore  tliroat 
and  the  sore  throat  wdiich  ushers  in  gangrenous  coryza.  A  definite 
expression  of 'opinion  must  then  be  deferred  to  a  later  date  ;  for  one 
cannot  be  absolutely  certain  whether  or  not  the  other  signs  of  gan- 
grenous coryza  will  appear. 

When  there  is  only  difficulty  in  swallowing  one  might  a  priori  sus- 
pect traumatic  injury  of  the  mucous  membrane,  with  or  without  the 
presence  of  a  foreign  body.  It  is  also  necessary  to  bear  in  mind  the 
possibility  of  difficulty  in  swallowing  being  occasioned  by  reflex  irritation 
without  local  lesions,  originating  in  enlargement  of  the  retropharyngeal 
lymphatic  glands  as  a  consequence  of  tuberculosis  or  other  disease. 

The  prognosis  is  favourable  ;  even  without  treatment  acute  pharyn- 
gitis usually  tends  to  recovery  in  eight  to  twelve  days,  and  rarely  becomes 
complicated.  Nevertheless,  some  reserve  ought  to  be  exhibited  in  cases  of 
pharyngitis  due  to  the  action  of  rough  forage,  the  removal  of  the  cause  being 
here  indispensable  to  any  improvement.  Similarly  in  cases  of  pharyngitis 
due  to  foreign  bodies  having  penetrated  the  mucous  membrane,  which 
are  chiefly  characterised  by  inability  to  swallow,  the  disease  may  continue 
for  a  very  much  longer  time  than  above  indicated,  unless  the  foreign 
body  is  discovered  and  removed.  Inflammation  is  limited  to  a  zone  sur- 
rounding the  point  of  implantation.  It  extends  more  deeply  with  move- 
ments of  the  foreign  body,  and  may  end  in  the  formation  of  an  abscess. 
Of  this  variety  is  Hopsomer's  remarkable  case,  in  which  a  darning- 
needle  finally  obtained  exit  through  the  submaxillary  space,  in  which  it 
had  caused  the  formation  of  an  abscess. 

Treatment.  The  treatment  is  the  same  whether  we  are  dealing  with 
a  simple  acute  pharyngitis  or  with  a  more  widely  distributed  inflannna- 
tion.  It  consists  in  smartly  stimulating  the  region  of  the  throat  with 
mustard,  cantharides  oil,  or  ointment,  or  with  an  ointment  containing 
2  per  cent,  of  tartar  emetic  and  of  bichromate  of  potash,  and  then  cover- 
ing the  parts  with  a  flannel  hood.  This  mode  of  treatment  seems 
preferable  to  that  recommended  by  German  authors — viz.,  the  applica- 
tion of  cold  compresses  to  the  throat,  the  administration  of  cold  gargles, 
etc.  Moderate  bleeding,  to  the  extent  of  two  or  three  quarts,  has  the 
great  advantage,  as  in  all  similar  cases,  of  lowering  the  temperature. 

This  treatment  may,  if  necessary,  be  completed  by  the  internal 
administration  of   3   to  5   drams  of  Kerme's  mineral   (oxysulphuret  of 


PSEUDO-MEMBRANOUS    PHARYNGltIS  iN   CATTLE.  141 

antimony)  in  electuary,  according  to  the  animal's  size.  Medicated 
inhalations  diminish  local  irritation,  render  swelling  less  painful^  and 
facilitate  the  separation  of  false  memhranes  and  the  discharge  of 
adherent   mucous    secretions. 

The  ordinary  food  should  be  rej^laced  by  cooked  roots,  lukewarm 
drinks  and  gruels,  all  rough  fodder  being  prohibited. 

If  difficulty  in  swallowing  alone  continues,  the  operator  should 
examine  the  mucous  membrane  of  the  pharyngeal  cavity  with  the  hand, 
in  order  to  discover  and  remove  any  foreign  body  which  may  have 
become  implanted  there. 

PSEUDO-MEMBRANOUS    PHARYNGITIS    IN    CATTLE. 

In  addition  to  the  above  acute  forms  of  pharyngitis,  a  pseudo-mem- 
branous, croupal,  or  pseudo-diphtheritic  pharyngitis  has  been  described  in 
the  ox.  It  is  due  to  polymicrobic  infection,  and  is  characterised  by  the 
formation  of  false  membranes  on  the  pharyngeal  mucous  membrane. 
The  condition  seems  to  be  a  pharyngitis  of  exceptional  intensity,  vary- 
ing markedly  from  the  classic  type  and  being  most  nearly  related  to 
severe  sore  throat,  laryngitis,  gangrenous  coryza,  etc. 

It  rarely  attacks  aged  cattle,  but  is  readily  transmissible  to  calves  and 
young  stock.  Cadeac  failed  to  inoculate  it  on  guinea-pigs  and  rabbits. 
Damman  succeeded  with  sheep  and  with  rabbits,  the  latter  dying  in 
twenty-four  hours  after  inoculation  with  hfemorrhage  at  the  seat  of 
puncture.  Loffler  hypodermically  infected  mice  and  produced  extensive 
infiltration  of  the  abdominal  walls,  and  often  of  the  peritoneum,  surface 
of  the  liver,  kidneys  and  intestine,  on  which  formed  a  thick  yellowish 
exudate  containing  the  organism. 

Causes.  Ldffier  found  filaments  of  a  long  delicate  bacillus  about  half 
the  thickness  of  the  bacillus  of  malignant  oedema.  The  bacillus  did  not 
grow  in  nutrient  gelatine  or  in  sheep's  blood  serum,  but  readily  grew  in 
blood  serum  of  the  calf.  Cadeac  gives  as  predisposing  causes  :  sudden 
chills,  rapid  alterations  of  temperature,  inhalation  of  irritant  vapours,  sup- 
pression of  cutaneous  secretion,  swallowing  irritant  liquids,  and  injuries. 

Symptoms.  The  nasal  membrane  is  reddened,  thickened  and  covered 
in  patches  with  false  membrane,  causing  snuffling  and  wheezing  breathing. 
The  throat  is  tender  and  swollen,  cough  is  frequent,  gurgling,  and  followed 
by  expulsion  of  false  membrane,  muco-pus  and  some  blood.  Shreds  of 
false  membrane  adhere  to  the  nose  and  lips.  Other  symptoms  are  :  fever, 
accelerated  pulse,  dark  mucous  membranes,  haggard  countenance,  mouth 
open,  hanging  tongue,  stringy  salivation,  and  constipation  or  diarrhoea. 

The  disease  runs  a  rapid  course,  and  death  may  occur  in  twenty-four 
hours.  Eecovery  may  be  equally  rapid,  but  often  convalescence  is 
protracted. 


142       DISEASES    OF    THE    SALIVARY    GLANDS,    TONSILS    AND    PHARYNX. 

Lesions.  Intense  congestion  of  mucosae  of  nose,  mouth,  pharynx, 
larynx,  and  bronchi,  with  here  and  there  patches  of  false  membrane, 
which  may  be  soft  or  tough,  according  to  the  duration  of  the  attack. 
The  deep  surface  of  the  false  memhranes  is  blood-stained  ;  and,  according 
to  Preitsch,  false  membranes  sometimes  occur  in  the  oesophagus,  rumen, 
and  omasum,  which  in  consequence  may  show  patches  of  ulceration. 

Treatment  (as  for  the  horse).  This  includes  poultices,  counter-irri- 
tants, laxatives,  febrifuges,  alkalies  and  antiseptics.  Inhalations  of  medi- 
cated vapour,  warm  water  to  which  has  been  added  some  antiseptic — 
carbolic,  lysol,  creolin,  camphor,  sulphurous  acid  ;  or  for  calves,  iodoform, 
oil  of  turpentine,  calcium  sulphide,  silver  nitrate,  coal  tar.  To  detach 
the  false  memhi'anes  ipecacuanha  and  potash  chlorate,  or  soda  sulphate, 
or  magnesia  sulphate  may  be  tried.  Papayin  and  pepsin  have  been 
suggested  as  appropriate  remedies.  Anyodnes — digitalis,  belladonna, 
morphia  and  aconite — may  be  useful.  Tracheotomy  is  indicated  as  a 
last  resort. 

PSEUDO-MEMBRANOUS    PHARYNGITIS    IN    SHEEP. 

Pioche-Lubin  states  that  this  is  common  in  flocks  as  a  result  of  moving 
the  sheep  in  dusty  enclosures.  The  dust  is  supposed  to  excite  the  intense 
croupous  inflammation  of  the  mucous  membrane.  The  disease  has  been 
noticed  in  spring  in  young  lambs  shortly  after  weaning.  Damman 
states  that  he  transmitted  the  disease  to  the  sheep  from  the  exudate  of 
the  calf. 

Symptoms.  Frotliy  salivation  with  constant  movements  of  the  jaws, 
viscid  nasal  discharge,  difficult  deglutition,  panting,  snufliing  breathing, 
throat  swollen  and  very  tender,  frequent  cough,  discharge  of  exudate.  The 
head  and  neck  are  extended,  the  eyes  dull,  appetite  is  lost,  the  mucous 
membranes  are  red  or  cyanotic,  and  the  animal  appears  weak  and  listless. 
As  respiration  becomes  more  difficult  the  mouth  is  held  open,  the  tongue 
is  protruded,  and  with  each  cough  shreds  of  false  membrane  are  expelled. 
Death  from  sufl'ocation  is  not  uncommon. 

The  lesions  are  not  different  from  those  seen  in  the  calf. 

The  treatment  is  similar  to  that  for  the  calf.  Tepid  drinks  con- 
taining hydrochloric  acid,  or  sulphate  of  soda  (1  lb.  to  50  sheep)  in  the 
drinking  water,  has  been  recommended.  Fumigation  with  sulphurous 
acid  or  chlorine  may  be  tried.  Small  numl)ers  may  be  treated  by  swab- 
bing the  throat  with  solution  of  sodii  hyposulphis  or  weak  caustics  and 
antiseptics. 


In  young  and  in  adult  pigs  pseudo-membranous  pharyngitis  is  often 
only  a  manifestation  of  pneumo-enteritis.    It  therefore  calls  for  no  special 


PHARYNGEAL    POLYPI.  143 

description  at  this  point.  No  exact  investigation  of  the  organisms  which 
produce  these  forms  of  pharyngitis  with  false  membrane  formation  has 
been  made  in  veterinary  surgery.  We  only  know  that  these  diseases  are 
not  true  diphtheria  due  to  "  Klebs'  bacillus."  Treatment  should  be  very 
energetic  from  the  commencement,  but  otherwise  it  differs  in  no  respect 
from  that  ordinarily  adopted. 

Tonics  and  stimulants,  like  alcohol,  wine,  coffee,  etc.,  are  indicated. 

[The  following  account  of  the  disease  is  summarised  from  Law's 
"  Veterinary  Medicine,"  Vol.  II.] 

"  Pseudo-membranous  pharyngitis  has  long  been  recognised  as  a 
contagious  disease  of  swine,  attacking  especially  swine  kept  in  herds 
or  in  close,  insanitary  pens.  Young  pigs  are  more  liable  to  attack  than 
older  animals,  perhaps,  owing  to  the  older  animals  having  suffered  the 
disease  in  early  life. 

Modern  observation  shows  that  pharyngitis  with  false  membranes 
is  common  in  swine  plague,  and  the  present  tendency  is  to  refer  all 
such  cases  to  that  category.  It  is,  however,  altogether  probable  that 
the  occurrence  of  local  irritation,  with  the  addition  of  an  irritant  or  septic 
microbe  altogether  distinct  from  that  of  swine  plague  or  hog  cholera, 
gives  rise  at  times  to  this  exudative  angina.  Certain  it  is  that  septic 
poisoning  with  the  food  is  not  at  all  uncommon  in  the  hog,  in  the  absence 
of  these  infectious  diseases. 

Symptoms  are  those  of  sore  throat,  with  much  prostration,  a  croaking 
cough,  yellow  discharge  from  nose  and  mouth,  and  marked  muscular 
weakness.  The  tongue,  tonsils  and  soft  palate  are  red,  swollen,  and 
studded  with  patches  of  false  membrane.  The  identification  of  swine 
plague  may  be  made  by  the  history  of  the  outbreak,  the  number  of 
animals  affected,  the  tendency  to  pulmonary  inflammation,  the  enlarged 
lymph  glands,  the  presence  of  the  non-motile  bacillus,  which  does  not 
generate  gas  in  saccharine  media,  and  which  readily  kills  rabbits  and 
pigs  with  pure  cultures  of  the  germ. 

Treatment.  Isolation,  cleansing  and  disinfection.  Locally  antiseptics 
and  generally  a  febrifuge  regimen  will  be  advisable." 

PHARYNGEAL    POLYPI. 

The  term  "pharyngeal  polypi"  includes  tumours  of  varying 
character,  which  affect  the  polypus  form,  and  occur  with  considerable 
frecpiency  in  the  bovine  species.  Many  of  these  polypi  are  simply  actino- 
mycotic growths  springing  from  the  pillars  of  the  fauces,  from  the 
upper  parts  of  the  palate  or  from  its  posterior  surface.  Less  frequently 
they  arise  from  the  lateral  walls  or  the  free  surface  of  the  hard  palate. 

Symptoms.  The  symptoms  are  so  characteristic  that  the  diagnosis 
rarely   presents    much   difficulty.      They  may  shortly  be   described    as 


144       DJSEASES    OF   THE    SALIVARY    GLANDS,    TONSILS    AND    PHARVNX. 

indicative  of  repeated  obstruction  in  the  pharyngeal,  cesophageal  or 
laryngeal  region.  At  the  moment  of  deglutition,  the  polypus  is  thrust 
towards  and  obstructs  the  oesophageal  orifice. 

Eeflex  stimuli  are  thus  excited,  which  prevent  deglutition;  an  attack  of 
coughing  occurs,  and  food  mixed  with  saliva  is  ejected  from  the  mouth 
and  nostrils.  The  attack  of  coughing  displaces  the  polypus  either 
in  a  forward  or  lateral  direction,  and  swallowing  then  again  becomes 
possible,  until  by  changing  its  position  the  growth  produces  fresh  signs 
of  obstruction. 

In  other  cases  the  polypus  may  only  be  of  such  small  size  as  to 
impede  the  food  passing  through  the  pharynx  on  its  way  into  the 
oesophagus  or  to  cause  difficulty  in  respiration  by  partially  blocking 
the  pharyngeal  portion  of  the  nasal  cavities.  In  such  cases  deglutition 
is  only  checked  and  rendered  slowei". 

Or  again,  the  pedicle  of  the  polypus  may  be  sufficiently  long  to  allow 
the  growth  at  certain  moments  to  fall  in  front  of  the  laryngeal  opening. 
Respiration  is  then  painful,  difficult  and  noisy.  Unless  the  growth  is 
displaced  during  the  subsequent  attack  of  coughing,  asphyxia  may  appear 
imminent,  or  may  even  occur  unless  assistance  is  afforded. 

Guided  by  these  symptoms,  the  operator  will  explore  the  pharynx 
manually,  and  thus  discover  the  position  and  size  of  the  tumour. 
Tumours  of  the  naso-pharynx  produce  very  similar  symptoms. 

The  prognosis  is  based  on  the  information  obtained  by  manually 
exploring  the  pharynx.  It  is  relatively  favourable  if  the  polypus  has  a 
well-marked  neck,  but  is  very  grave  if  the  tumour  is  largely  sessile  and 
cannot  be  removed. 

Treatment.  Medical  treatment  ajipears  useless  except  in  cases  of 
polypi  due  to  the  presence  of  actinomyces.  The  administration  of  iodine 
and  iodide  of  potassium,  in  large  doses,  may  then  lead  to  resorption ;  but 
extirpation  is  often  preferable. 

In  other  cases  extirpation  is  the  only  rational  treatment.  The 
operation  necessitates  the  performance  of  provisional  tracheotomy  in 
order  to  avoid  risk  of  asphyxia.  The  growth  may  be  directly  removed 
through  the  buccal  cavity  without  incision,  provided  that  it  prove  pos- 
sible to  pass  the  chain  of  an  ecraseur  around  the  pedicle  ;  or  through  the 
buccal  cavity,  with  incision,  after  vertically  or  obliquely  dividing  the  soft 
palate ;  or,  lastly,  through  the  larynx,  after  performing  median  laryn- 
gotomy,  thus  obtaining  access  to  the  pharynx. 

Only  the  first  method  of  intervention  is  to  be  recommended ;  the  last 
two  are  more  delicate.  They  necessitate  after-treatment,  and  when  the 
patients  are  in  a  condition  for  slaughter  it  is  frequently  preferable  to 
send  them  to  the  butcher.  The  essential  point  is  not  to  act  without  a 
full  knowledge  of  the  causes. 


CHAPTER    III. 
DISEASES    OF    THE    OESOPHAGUS* 

The  CL'sophageal  tube  is  of  very  simple  anatomical  construction,  and 
performs  an  equally  simple  physiological  function ;  nevertheless,  in  the 
ox  it  is  liable  to  a  large  number  of  diseased  conditions.  These  con- 
ditions may  affect  only  a  circumscribed  area  of  the 
mucous  membrane  or  the  entire  extent  of  the  tube. 
Agahi,  both  the  muscular  and  mucous  tissues  may 
be  affected,  as  in  inflammation  of  the  oesophagus 
accompanied  or  followed  by  contraction,  and  in  the 
formation  of  (esophageal  abscesses  and  tumours ; 
or  the  muscular  tissue  alone  may  be  affected,  as  Fm.  64.— Schema  il- 
in  cases  of  dilatation.  Even  where  no  lesion  is  .  l^s^'i'ating  anatomy 
apimrent   the  normal  rhythm  of   deglutition  may  °     ,^^  oesopiagus. 

.^     .    ,      f        -,        -.1    •      •- •.  1        ^-u  n  ^    strong    external 

1)6   niterfered  with,   either   by  the   presence   of   a  |      j,  ^^  muscle,  in- 

foreign  body  (obstruction)  or  by  spasm  of  the  mus-  temiediate  cellulo- 

cular  layers  (oesophagismus)  or  by  compression  due  elastic  layer,  inner' 

to  tissues  surrounding  the  oesophagus  (false  con-  ^^y^^    °^    mucous 

tractions) .  "o^s ^XV  able  of 

We  shall  successively  study  the  different  forms  ^^,^,^^  dilatation 

of  oesophagitis,  contraction,  and  dilatation,  together 

with  their  complications ;  then  obstructions,  ruptures  of  the  oesophagus, 
oesophagismus,  and  false  contractions. 


(ESOPHAGITIS. 

Inflammation  of  the  oesophagus  may  be  due  to  many  different  causes, 
and  may  occur  in  one  of  three  different  degrees  of  severity.  It  may 
be  either  superffcial,  i.e.,  limited  to  the  epithelial  layer  of  the  mucous 
membrane ;  or  deep,  affecting  the  entire  thickness  of  the  mucous  mem- 
brane (epithelium,  corium,  and  oesophageal  glands) ;  or,  finally,  it  may 
attack  both  the  mucous  and  muscular  layers.  German  authors  recog- 
nise various  divisions,  such  as  erythematous,  catarrhal,  follicular,  and 
phlegmonous  oesophagitis.  In  reality  these  are  not  always  different  forms, 
but  simply  successive  stages  in  the  evolution  of  a  single  morbid  condition. 

D.C.  L 


146  DISEASES   OF   THE   (ESOPHAGUS. 

Here  we  shall  only  study  the  ordinary  forms  of  oesophagitis,  leaving 
on  one  side  those  which  occur  symptomaticall}'  during  foot-and-mouth 
disease,  cattle  plague^  gangrenous  coryza,  actinomycosis,  etc. 

Causation.  The  causes  of  oesophagitis  may  be  divided  into  three 
groups  of  different  character: — (a)  Eough  fodder  (clover  containing  wrest- 
harrow,  thistles,  thorns,  furze,  or  splinters  of  wood,  etc.)  must  he  placed 
in  the  first  rank,  for  its  repeated  action  abrades  and  irritates  the  mucous 
membrane  to  such  an  extent  as  finally  to  produce  inflammation.  This 
inflammation  usually  remains  superficial  and  of  moderate  intensity  ;  its 
occurrence  can  be  anticipated  during  years  of  scarcity,  when  the  animals 
feed  on  rough  and  irritating  material  like  fern,  broom,  heather,  furze,- etc. 

(h)  Hot  drinks,  whether  in  the  nature  of  beverages  or  medicinal 
draughts,  are  a  frequent  cause  of  cesophagitis  if  administered  by  careless 
or  inexperienced  persons.  The  mucous  membrane  is  scalded  over  a 
varying  area  and  with  different  degrees  of  severity,  or  is  destroyed 
by  the  chemical  action  of  such  drugs  as  ammonia,  dilute  acids,  iodine 
solution,  etc. 

(c)  Eough  or  clumsy  manipulation  in  withdrawing  or  displacing 
foreign  bodies,  or  merely  passing  the  probang,  produces  that  variety  of 
cesophagitis  termed  traumatic.  In  clumsy  hands  oesophageal  sounds  or 
catheters  may  abrade  or  even  tear  the  mucous  meml)rane  and  sul)jacent 
tissues. 

Symptoms.  These  vary  to  some  extent,  according  to  the  intensity 
of  the  inflammatory  phenomena.  If  the  lesions  are  superficial  and  only 
implicate  the  epithelium,  as  in  catarrhal  oesophagitis,  the  symptoms  often 
pass  unnoticed,  and  only  produce  difficulty  in  swallowing.  When  inflam- 
mation has  involved  the  entire  thickness  of  the  mucous  membrane  the 
immediate  consequence  is  loss  of  appetite  due  to  pain  during  swallowing. 
After  the  bolus  of  food  has  been  masticated,  and  has  passed  into  the 
pharynx,  the  animal  stretches  out  its  head  and  neck  and  seems  to  be 
making  efforts  to  force  it  down  the  oesophageal  canal.  The  progress  of 
the  bolus  is  slow  and  clearly  difficult. 

In  oesophagitis  due  to  scalding  the  blisters  are  soon  broken  by  the 
passage  of  food,  the  corium  is  exposed,  and  the  animal  has  equal  difficulty 
in  swallowing  either  solids  or  liquids.  The  reflex  action  provoked  by  the 
passage  of  the  food  over  these  lesions  may  be  so  violent  that  the  ingesta 
never  arrive  at  the  stomach,  but  are  violently  rejected  by  a  sudden  and 
unexpected  antiperistaltic  contraction.  Even  saliva  is  returned.  More- 
over, in  these  cases  the  history  is  generally  clear,  and  the  animal  is 
feverish  or  greatly  depressed.  These  objective  symptoms  are  very 
significant,  and  when,  in  addition,  an  abnormal  and  exceptional  degree 
of  sensibility  is  detected  at  some  point  by  palpation,  they  unmistakably 
indicate  the  existence  of  cesophagitis. 


(ESOPHAGITIS.  147 

The  irregularity  in  deglutition,  and  therefore  also  in  rumination, 
sometimes  excites  moderate  tympanites  without  any  very  apparent  cause. 
Should  the  condition  still  appear  doubtful  the  oesophageal  sound  may  be 
passed,  but  with  great  care.  It  generally  aggravates  the  pain  and  pro- 
duces intense  antiperistaltic  movements,  which  the  practitioner  should 
not  attempt  to  overcome. 

Complications.  If  cesophagitis  is  moderate,  recovery  is  the  rule. 
The  symptoms  of  pain  gradually  diminish. 

When,  on  the  contrary,  inflammation  is  very  intense,  as  in  certain 
cases  of  traumatic  cesophagitis,  the  injured  spot  may  become  infected 
and  suppuration  follow.  The  existing  fever  then  persists  or  becomes 
more  marked ;  the  animal  is  extremely  depressed ;  respiration  may  be 
difficult  and  accelerated,  and  aj^jDetite  is  entirely  lost. 

If  the  (esophageal  abscess  remains  submucous  the  diagnosis  is 
difficult,  but  it  is  often  problematical,  even  when  the  abscess  develops 
ill  the  cervical  region.  The  jugular  furrow  (usually  on  the  left  side) 
becomes  the  seat  of  a  severe  diffuse  inflammatory  swelling,  the  course  of 
^\hich  clearly  indicates  the  development  of  the  symptoms.  In  exceptional 
cases  fluctuation  may  be  detected. 

If  from  the  first  the  abscess  develops  around  the  cesophagus  or  in  the 
course  of  suppuration  comes  to  occupy  this  position,  swelHng  in  the 
jugular  furrows  is  more  apparent  and  easier  to  detect,  and  in  this  case 
fluctuation  may  be  localised.  When  the  lesions  are  within  the  thorax 
no  tangible  symptoms  can  be  detected.  Death  may  occur  in  a  few  days, 
when  an  abscess  in  the  lower  cervical  region  breaks  into  the  anterior 
mediastinum,  or  when  an  abscess  in  the  thoracic  region  opens  into  the 
pleural  cavity.  In  cesophagitis  produced  by  scalding  and  from  swallowing 
hot  or  caustic  liquids  the  mucous  membrane,  and  sometimes  the  muscular 
tissue,  is  destroyed,  and  ulcerations  and  cicatrices  result,  or  the  oesophagus 
may  even  be  perforated,  with  rapidly  fatal  results  ;  even  when  recovery 
occurs,  cicatrices  form  and  cause  very  grave  contraction. 

Diagnosis.  The  diagnosis  is  generally  easy,  provided  that  the 
symptoms  noted  are  methodically  analysed  and  the  history  of  the 
case  is  taken  into  consideration. 

Prognosis  is  favourable  in  ordinary  cases.  On  the  other  hand,  it 
may  be  very  grave  when  general  symptoms  become  marked,  when  the 
vital  functions  are  disturbed  and  a  deep-seated  abscess  appears  to  be 
forming. 

Lesions.  In  the  first  degree  the  lesions  are  confined  to  inflammation 
and  desquamation  of  the  epithelium ;  in  the  second,  to  inflammation  of 
the  corium  and  of  the  mucous  membrane ;  in  the  third,  to  infiltration  of 
the  submucous  layers  and  of  the  muscular  and  pericesophageal  tissues. 
Sloughing  and  perforation  follow  the  administration  of  caustic  liquids. 

L  2 


148  DISEASES    OF    THE    (ESOPHAGUS. 

Treatment.  As  the  direct  application  of  medicines  to  the  inflamed 
mucous  menibiane  can  only  be  of  a  momentary  character,  treatment  is 
confined  to  administering  emollient,  anodyne,  and  slightly  astringent 
drinks,  the  action  of  which  is  assisted  by  feeding  with  milk,  farinaceous  or 
mucilaginous  foods.  Under  these  circumstances  recovery  occurs  in  ten 
to  fifteen  days.  The  application  of  stimulant  or  blistering  ointments 
along  the  jugular  furrow  may  have  a  good  effect. 

When  the  general  condition  of  the  patient  becomes  aggravated,  and 
the  formation  of  an  abscess  appears  certain,  it  is  best  to  recommend 
slaughter.  In  the  case  of  a  submucous  abscess  the  passage  of  the  pro- 
bang  may,  however,  predispose  or  cause  the  abscess  to  open  into  the 
oesophagus,  and  thus  lead  rapidly  to  recovery,  but  tliis  is  exceptional. 
The  "pointing"  of  the  abscess  and  its  opening  towards  the  jugular 
furrow  may  be  followed  by  temporary  improvement,  but  at  a  later  stage 
is  followed  by  fistala  formation,  or  by  contraction  of  the  cesophagus 
itself.     From  an  economic  standpoint  it  is  better  to  slaughter. 

STRICTURE    OF    THE    CESOPHAGUS. 

Under  normal  conditions  the  cavity  or  lumen  of  the  oesophageal  tube 
is,  so  to  speak,  imaginary :  the  walls  of  the  tube  lie  flatly  together,  and 
the  mucous  membrane  is  in  folds.  During  the  act  of  swallowing  the 
tube  becomes  dilated  to  a  degree  varying  with  the  size  of  the  bolus  of 
food,  and  again  retracts  as  soon  as  deglutition  is  effected.  Whenever  the 
dilatability  of  the  tube  is  markedly  diminished  by  changes  in  its  walls, 
and,  in  a  much  higher  degree,  when  this  dilatability  has  disappeared, 
true  stricture  exists.  In  the  former  case  small  boluses  of  food  and 
liquids  alone  succeed  in  passing  the  stricture  ;  in  the  latter,  liquids  alone 
can  pass. 

Causation.  Strictures  are  never  primary.  They  result  from  intense 
■attacks  of  cesophagitis,  ending  in  sclerosis  of  the  mucous  coat,  extensive 
ulceration  consequent  on  scalding,  or  interstitial  inflammation  affecting 
the  muscular  coats,  which  then  become  thickened  or  sclerosed. 

Internal  injuries  due  to  attempts  to  withdraw^  or  propel  foreign 
bodies  along  the  oesophagus  may  also  cause  strictures. 

Lesions.  In  simple  strictures  the  lesions  are  confined  to  the  develop- 
ment in  the  depths  of  the  mucous  membrane  and  in  the  muscular  layers 
of  inflammatory  tissue,  which  becomes  denser  with  lapse  of  time.  This 
alters  the  character  of  the  walls  and  the  structure  of  the  tissues,  and 
causes  them  to  lose  their  elasticity.  After  extensive  ulceration  the  tissue 
of  the  cicatrix  contracts  and  hardens  to  a  very  varying  degree. 

Symptoms.  The  apparent  symptoms  are  very  clearly  marked ;  the 
appetite  is  good,  and  the  animal  masticates  as  usual,  but  in  the  act 
of   deglutition   is  seen  to  extend  the  head  on  the  neck,  and  to  make 


STRICTURE    OF   THE   (ESOPHAGUS. 


149 


m 


efforts  to  swallow,  which  prove  unavaiHiig  when  the  contraction  is 
too  marked.  A  reflex  antiperistaltic  movement  often  causes  the  sub- 
stances ingested  to  be  at  once  rejected.  These  violent  efforts,  however, 
in  time  provoke  dilatation  above  the  stricture.  A  quantity  of  food 
accumulates  in  this  dilatation,  and  the  symptom  so  characteristic  of 
cesophageal  stricture  then  appears — viz.,  regular  regurgitation.  The 
second  constant  symptom  associated  with  compression  or  obstruction 
of  the  oesophagus  is  tympanites  after  feeding,  however  trifling  may 
be  the  amount  swallowed.  Eumination  is 
suspended,  and  even  eructation  of  gas  is 
difficult.  Finally,  the  characteristic  sign  of 
stricture  is  noted  on  passing  the  probang, 
which  reveals  the  existence  of  the  condition, 
indicates  its  position,  and  suggests  its  degree 
of  development. 

Diagnosis.  Strictures  only  develop  pro- 
gressively and  slowly,  a  fact  which  enables 
them  to  be  differentiated  from  oesophagitis. 
It  is  more  difficult  to  differentiate  them 
from  dilatations,  because  the  stricture  always 
ends  by  becoming  complicated  with  dilata- 
tion ;  but  this  distinction  is  of  little  prac- 
tical importance,  the  consequences  being 
identical. 

Prognosis.  The  prognosis  is  very  grave, 
and  there  is  no  economic  reason  for  attempt- 
ing treatment  except  in  special  cases  ;  the 
indications  are  in  the  direction  of  slaughter. 

From  the  economic  standpoint  there  is 
no  treatment.  Basing  their  actions  on 
human  practice,  the  Germans  have  recom- 
mended progressive  dilatation  of  the  lumen  of  the  oesophagus  by  passing 
a  series  of  catheters  of  gradually  increasing  size.  What,  however,  is 
justifiable  in  human  medicine,  where  the  only  object  is  to  keep  the 
patient  alive  at  any  cost,  may  be  highly  objectionable  in  veterinary 
practice  ;  and  in  the  present  instance  this  is  the  case.  Except  in  very 
rare  instances,  which  the  practitioner  alone  can  apj)reciate,  dilatation  is 
contra-indicated,  and  the  owner's  interest  lies  in  slaughtering  the  animal 
before  it  has  lost  much  condition. 


Fig.  65. — Scliema  of  recent 
and  old-standing  contraction 
of  the  oesophagus.  R,  simple 
contraction ;     D,    secondary 

dilatation. 


DILATATION    OF    THE    CESOPHAGUS. 

Dilatations  are  more  frequent  than  strictures.     Their  mode  of  origin 
is  easily  understood.     When  the  muscular  tissue  has  lost  its  tonicit}'  and 


150 


DISEASES   OF   THE   (ESOPHAGUS. 


contractile  power  at  a  given  point,  or  when,  as  a  consequence  of  any  form 
of  inflammation,  it  has  begun  to  undergo  atrophy,  the  mucous  membrane 
becomes  herniated,  because  its  circumference  is  not  supported  regularly 
during  deglutition.  The  ectasia,  which  at  first  is  of  small  size,  becomes 
more  marked  in  consequence  of  the  tendency  that  exists  for  the  food  to 
accumulate  in  the  dilated  region.     Dilatation  is  thus  set  up. 

Localised  attacks  of  oesophagitis,  accidental  injuries  and  fissuring  of 
the  oesophageal  muscular  tissue,  produced  by  clumsy  efforts  to  displace 
foreign  bodies  with  the  probang,  are  the  principal 
causes  of  dilatation.  When  the  probang  is  impru- 
dently or  clumsily  manipulated,  it  may  press  exces- 
sively at  any  point  where  the  oesophagus  makes  a 
slight  bend,  and  thus  split  the  contracted  muscular 
coat  without  injuring  the  lax  mucous  membrane. 

Oesophageal  contractions,  as  we  have  seen,  may 
form  the  point  of  origin  of  dilatations,  but  in  this 
case  the  dilatations  are  more  regular  in  form,  and 
affect  the  entire  circumference  of  the  tube.  The 
muscular  tissue  is  still  everywhere  normal,  and 
becomes  dilated  in  consequence  of  equally-applied 
excentric  pressure. 

Symptoms.  When  the  dilatation  develops 
slowly  and  progressively,  as  a  consequence  of  mus- 
cular atrophy,  the  symptoms  remain  unnoticed  for 
a  long  time,  and  the  owner  only  begins  to  be 
anxious  when  the  animal  loses  condition,  or  when 
the  driver  or  cowman  detects  masses  of  half-chewed 
food  mixed  with  the  saliva  in  the  manger. 

Certain  signs  are  pathognomonic  ;  others  may 
be  regarded  as  of  secondary  importance.  By  care- 
fully watching  an  animal  which  is  feeding  the 
following  symptoms  may  be  noted :  As  a  general 
rule  hunger  is  very  marked,  and  the  animal  chews 
its  food  and  swallows  the  first  few  mouthfuls  in  a  perfectly  normal  way. 
Three,  five,  eight,  or  even  ten  mouthfuls  may  be  swallowed ;  then  the 
animal  suddenly  stops,  appears  a  little  anxious,  extends  its  head  and 
neck,  an  antiperistaltic  contraction  occurs,  and  one  or  two  masses  of 
food  are  rejected  and  fall  into  the  manger.  The  discomfort  being  thus 
momentarily  relieved,  the  animal,  which  is  dying  of  hunger,  although 
faced  with  food  which  it  is  unable  to  swallow,  returns  to  its  meal,  swallows 
one,  two,  or  three  boluses  of  food,  regurgitation  again  occurs,  and  the 
whole  process  is  repeated. 

What  is  going  on  under  these  circumstances  is  easy  to  explain. 


J 


Fig.  66. — Schema  of 
oesophageal  stricture 
(the  muscular  layer 
above  the  stricture 
has  undergone  atro- 
phy ;  the  mucous 
membrane  is  di- 
lated). 


DILATATION    OF   THE    (ESOPHAGUS.  151 

At  the  commencement  of  the  meal  the  dilatation  is  usually  empty,  or 
nearly  empty.  A  mouthful  of  food  is  swallowed.  It  descends  the  oeso- 
phagus until  it  arrives  at  the  diverticulum,  into  which  it  partially  or 
wholly  passes,  the  peristaltic  wave  of  contraction  ceasing  at  this  point. 
The  second  mouthful  follows  with  the  same  result,  then  a  third,  a  fourth, 
etc.  The  diverticulum  soon  hecomes  filled  to  repletion,  and  no  more  food 
can  enter  it.  The  food  therefore  accumulates  in  the  upper  portion  of  the 
oesophageal  tube  until  the  latter  becomes  nearly  filled ;  but  as  this  tube, 
provided  its  innervation  is  intact,  is  intolerant  of  the  presence  of  any 
foreign  body,  and  as  efforts  to  swallow  prove  fruitless,  a  sudden  anti- 
peristaltic wave  of  contraction  occurs,  with  the  result  that  all  the  material 
contained  in  the  tube  above  the  dilatation  is  ejected  into  the  mouth, 
whence  it  falls  into  the  manger.  The  same  result  follows  any  further 
attempts  to  swallow  during  a  particular  feeding  time.  From  this  it  will 
be  seen  that  the  animal  can  ingest  at  a  given  time  only  as  much  as  the 
dilatation  will  contain. 

In  the  intervals  between  meal  times  and  under  the  action  of  the  saliva 
and  warmth,  the  food  collected  in  the  dilatation  becomes  softened,  breaks 
down,  and  slowly  moves  onward  towards  the  rumen.  When  the  next 
feeding  time  arrives  the  dilatation  is  almost  empty,  and  the  same  set  of 
symptoms  recurs. 

If,  instead  of  forage,  the  animal  begins  by  taking  gruel  or  very  fluid 
material,  deglutition  appears  normal,  or  at  least  fairly  easy  ;  but  if  drinking 
is  deferred  until  after  taking  hard  food,  it  becomes  almost  impossible, 
because  the  passage  is  obstructed.  These  symptoms  are,  so  to  speak, 
pathognomonic.  Under  any  circumstances  they  are  so  significant  that 
error  in  diagnosis  is  unlikely. 

By  careful  examination  oesophageal  regurgitation  can  very  easily  be 
distinguished  from  true  vomiting  ;  the  character  of  the  rejected  material 
shows  that  it  has  not  come  from  the  stomach,  while  the  boluses  of  food 
preserve  their  cylindrical  form,  and  are  still  saturated  with  saliva. 

Some  secondary  signs  also  deserve  to  be  mentioned,  such  as  the 
animal's  anxiety  and  restlessness  whilst  its  neighbours  are  feeding,  the 
existence  of  trifling  and  intermittent  tympanites  due  to  suppressed 
eructation,  suppression  or  irregularity  of  rumination,  constipation,  etc. 
At  a  later  stage  there  is  rapid  wasting  and  disordered  appetite,  and 
finally  the  patients  die  slowly  of  hunger,  whatever  efforts  are  made  to 
feed  them. 

When  the  seat  of  dilatation  is  in  the  cervical  portion  of  the  oesophagus, 
there  are  other  symptoms  which  leave  no  doubt  as  to  the  condition. 
When  empty  the  pouch  cannot  be  detected  ;  but  during  a  meal  the  accu- 
mulation of  food  causes  it  to  assume  the  appearance  of  a  doughy,  diffuse, 
indolent  swelling,  which  alters  the  outline  of  the  jugular  furrow,  yields 


lo2  Diseases  of  the  (f.sopHAGts. 

to  in-essiire,  and  sometimes  produces  respiratory  disturbance  by  pressing 
on  the  trachea,  the  pneumo-gastric  and  inferior  laryngeal  nerves,  etc. 

When  the  dilatation  is  intra-thoracic  and  the  above-described  symptoms 
have  been  observed,  the  dilated  spot  can  only  be  detected  and  localised  by 
using  the  probang.  The  greatest  possible  prudence,  however,  is  required 
in  manipulating  the  instrument,  in  order  to  avoid  rupturing  the  thin  walls 
of  the  dilated  portion. 

The  diagnosis  is  not  always  easy ;  when  food  is  regurgitated,  and 
one  finds  by  auscultation  that  the  sound  usually  produced  by  the  passage 
of  solids  or  liquids  into  the  rumen  is  absent,  there  need  be  no  hesitation 
in  diagnosing  either  a  dilatation  or  a  stricture.  The  clinical  consequences 
being  the  same,  the  possible  error  would  be  of  little  importance. 

Prognosis.  The  animal's  life  is  rarely  in  immediate  danger,  but  from 
the  economic  point  of  view  the  j^rognosis  is  extremely  grave,  and  it  is  in 
the  owner's  interest  to  slaughter  the  animal  as  soon  as  possible  in  order 
to  avoid  loss.  Even  in  cases  of  dilatation  in  the  cervical  region,  surgical 
interference  is  not  advisable. 

Treatment.  As  foreshadow^ed  by  what  has  been  said,  there  is  no 
rational  economic  treatment.  When  the  dilatation  is  in  the  cervical  region, 
one  might  in  exceptional  cases  attempt  to  restore  the  regular  calibre  of 
the  oesophagus  by  removing  an  elliptical  portion  of  mucous  membrane, 
and  bringing  the  muscular  tissue  together  w'ith  sutures  ;  that  is  to  say, 
when  the  rupture  or  fissuring  of  the  muscular  coat  has  been  accidental. 
But  as  one  is  usually  unable  to  remove  the  primary  cause,  to  which  the 
change  in  the  muscular  tissue  is  essentially  due,  the  dilatation  would 
recur  without  the  operation  having  conferred  any  benefit. 

When  an  exact  diagnosis  has  been  made,  the  only  useful  indication 
is  to  confine  the  animal  to  very  fluid  food,  which  will  not  obstruct  the 
oesophagus.     Ordinary  forage  should  be  withheld. 

CESOPHAGEAL    OBSTRUCTIONS. 

In  this  chapter  we  shall  only  consider  such  obstructions  as  occur  in 
consequence  of  the  animal  having  attemi)ted  to  swallow  without  sufficiently 
chewing  objects  which  become  arrested  in  the  oesophagus. 

Obstruction  is  termed  "total"  or  "  partial,"  according  as  the  obstructing 
l)ody  fills  the  entire  calibre  of  the  oesophagus  at  the  point  of  obstruction, 
or  only  occupies  a  part  of  the  space.  Partial  obstructions  produced  by 
Ijeet  and  turnip  tops,  etc.,  are  usually  but  momentary  ;  liquids  and  saliva 
are  still  able  to  pass  between  the  obstruction  and  the  walls  of  the  tube, 
and  as  soon  as  the  arrested  food  becomes  a  little  softened  it  is  displaced 
and  the  oesophagus  again  becomes  patent. 

Causation.  The  circumstances  under  which  this  accident  occurs  are 
extremely  easy  to  understand.      Obstructions  are  produced  by  apples, 


(Esophageal  obstructions.  153 

potatoes,  .turnips,  carrots,  cabbage-stalks,  beetroots,  etc.,  which,  whether 
shced  or  not,  are  swallowed  gluttonously.  Not  having  been  sufficiently 
comminuted,  and  being  of  larger  size  than  the  cesophagus  can  readily 
accommodate,  they  become  arrested  at  some  point  between  the  com- 
mencement of  the  oesophagus  or  a  few  inches  behind  the  pharynx,  or 
just  in  front  of  the  point  of  entry  of  the  gullet  into  the  stomach.  The 
latter  is  the  commonest  position,  though  not  infrequently  the  ol)struction 
occurs  in  the  intra-thoracic  portion. 

It  may  occur  in  the  stable,  but  is  commoner  in  animals  which,  having 
broken  loose,  have  entered  orchards,  gardens  or  potato  or  turnip  fields 
and  attempted  to  swallow  apples,  cabbages,  potatoes,  etc.,  found  there. 

In  sheep,  obstruction  of  the  oesophagus  is  due  to  similar  causes,  but 
in  their  case  the  above-mentioned  objects  are  replaced  by  small  wild 
apples,  turnip  shells,  Jerusalem  artichokes,  horse-chestnuts,  carrots,  etc. 

The  symptoms  may  be  divided  into  general  and  local. 

General  symptoms.  As  soon  as  the  foreign  body  becomes  fixed  in 
position,  the  animal  begins  to  make  exceptional  efforts  to  swallow.  The 
head  is  extended  on  the  neck,  and  the  oesophagus  and  the  muscles  sur- 
rounding the  trachea  are  violently  contracted.  These  efforts  proving 
fruitless,  feeding  is  necessarily  stopped,  and  the  animal  at  once  appears 
slightly  anxious. 

Very  soon  afterwards  salivation  sets  in,  saliva  l)eing  continuously 
secreted.  If  the  obstruction  is  total,  the  saliva  cannot  be  swallowed, 
and  is  either  returned  in  quantities  l)y  antiperistaltic  movements  or 
escapes  in  frothy  filaments  from  the  mouth. 

Tympanites  is  not  long  in  appearing.  It  is  progressive,  and  results 
both  from  arrest  of  eructation  and  from  continued  fermentation  in  the 
rumen.  It  may  eventually  come  to  a  standstill,  or  may  continue  and 
threaten  to  produce  asphyxia. 

Local  symptoms.  The  local  symptoms  are  ditiicult  to  appreciate, 
except  in  cases  of  cervical  obstruction.  Sometimes  the  foreign  body 
produces  a  local  swelling,  which  changes  the  outline  of  the  jugular 
furrow,  most  frequently  on  the  left  side.  In  many  cases  it  can  only 
be  detected  by  manipulating  the  i^arts  between  the  trachea  and  the 
lower  surface  of  the  cervical  vertebrae.  "When  the  obstruction  is  within 
the  thorax,  the  probang  alone  can  detect  its  position. 

Diagnosis.  The  diagnosis  is  usually  easy.  The  history  and  the 
observed  symptoms  are  often  very  clear,  and  the  suddenness  with  which 
the  obstruction  has  made  its  appearance  prevent  the  condition  from 
being  confused  with  dilatation  or  stricture. 

The  prognosis  is  very  variable.  It  is  often  easy  to  remove  the 
obstacle  ;  in  other  cases  intervention  is  difficult,  and  death  ma}'  occur 
rapidly. 


154  DISEASES   OF   THE    (ESOPHAGUS. 

Treatment  is  confined  to  one  essential  point — removal  of  the 
obstruction.  The  chief  difficult}^  lies  in  choosing  the  mode  of  inter- 
vention. Moreover,  success  depends  on  several  factors,  which,  in  the 
order  of  their  imi)ortance,  are  as  follows  :  the  size  of  the  ol)structing 
body ;  the  time  which  has  elapsed  since  the  accident  occurred ;  the 
bodily  condition  of  the  animal — i.e.,  whether  it  be  fat  or  thin — and  the 
extent  to  which  tympanites  has  developed. 

The  first  thing  to  do  (and  in  favourable  cases  all  that  is  required)  is 
to  puncture  the  rumen  and  leave  the  canula  for  some  time  in  position. 
The  onward  progress  of  the  foreign  body,  especially  when  the  obstruc- 
tion is  in  the  intra-thoracic  portion  of  the  tube,  is  often  impeded  by  the 
tympanites,  which  tends  to  thrust  the  object  towards  the  pharynx,  or  at 
least  to  fix  it  in  position.  In  consequence  of  a  sudden  change  in  the 
conditions  of  pressure  the  foreign  body  may  move  and  pass  into  the 
rumen ;  all  danger  is  then  at  an  end. 

Even  though  the  obstruction  does  not  immediately  cease,  puncture  of 
the  rumen,  by  removing  the  danger  of  asphyxia,  allows  one  at  least  to 
wait  for  several  hours,  sometimes  until  next  day,  during  which  time  the 
object  may  pass  into  the  rumen  without  further  extraneous  assistance. 
The  other  methods  may  be  grouped  into  four  series : 

I.  External  taxis.  This  is  directed  towards  loosening  the  foreign 
body  and  thrusting  it  towards  the  pharynx  and  buccal  cavity.  It  can 
only  be  used  against  obstructions  in  the  cervical  region.  Two  methods, 
although  very  ancient,  are  still  practised. 

{a)  The  first  is  carried  out  in  the  following  way :  the  animal  is  fixed 
to  a  post  or  tree  so  that  it  cannot  struggle,  its  head  being  drawn  up  as 
high  as  possible.  The  operator  stands  on  the  left  side,  with  his  back 
turned  towards  the  patient's  head,  his  left  hand  is  pressed  into  the  right 
jugular  furrow,  his  right  hand  is  placed  on  the  left  jugular  furrow  imme- 
diately below  the  foreign  body.  By  using  the  fingers  the  foreign  body 
is  moved,  and  is  progressively  thrust  towards  the  pharynx,  in  spite  of  the 
animal's  efltbrts  to  swallow.  In  carrying  out  this  manipulation  it  is 
absolutely  indispensable  not  to  let  slip  the  obstructing  body  for  a  single 
instant,  otherwise  the  peristaltic  action  will  immediately  return  it  to  its 
former  place.  When  it  has  been  raised  as  far  as  the  pharynx,  an 
assistant  passes  his  hand  into  the  back  of  the  mouth,  as  indicated  in  a 
former  chapter,  seizes  the  object  and  withdraws  it ;  or,  instead,  the 
assistant  takes  over  the  operator's  duties,  while  the  latter  himself 
extracts  the  foreign  body. 

{h)  In  the  second  method  the  animal  is  tixed  in  a  different  position, 
the  head  being  held  about  10  to  12  inches  from  the  ground,  with  the 
neck  lowered  and  inclined  towards  the  earth.  As  in  this  position  the 
oesophagus  is  longitudinally  relaxed,  and  can  be    dilated  to   its  fullest 


OESOPHAGEAL   OBSTRUCTIONS. 


155 


extent  transversely,  the  difficulty  of  displacing  the  obstacle  should  be 
very  much  less.  In  this  case  the  operator  always  stands  on  the  left  side 
of  the  neck,  but  with  his  back  towards  the  animaVs  body.  The  right 
arm  is  passed  around  the  neck  and  the  right  hand  pressed  into  the 
right  jugular  furrow,  the  left  hand  being  similarly  engaged  in  the  left 
jugular  furrow.  The  method  of  employing  the  fingers 
is  identical,  or  instead  of  the  fingers  the  thumbs  may 
be  used. 

When  the  obstructing  object  has  been  lifted  as  far 
as  the  pharynx  it  has  a  tendency  to  fall  out  of  the 
mouth,  and  if  it  fail  to  do  so  it  can  be  fixed  in  position 
and  removed  as  in  the  preceding  case. 

II.  Extraction.  These  methods  are  applicable  to 
cases  where  the  foreign  body  has  become  fixed  in  the 
cervical  region,  but  more  especially  to  obstructions  in 
the  intra-thoracic  part  of  the  oesophagus.  In  the 
majority  of  cases  they  are  dangerous,  and  may  lead 
to  pinching,  rupture,  or  perforation  of  the  cesophageal 
mucous  membrane.  They  should  therefore  be  re- 
garded as  exceptional  measures.  Theoretically,  the 
instruments  described  are  perfect,  but  practically  they 
do  not  secure  the  results  anticipated,  because  one  can 
never  prevent  displacement,  wrinkling,  and  involution 
of  the  cesophageal  mucous  membrane. 

The  forceps  probang  has  the  drawback  of  seldom 
grasping  smooth  foreign  bodies  with  sufficient  firm- 
ness to  permit  of  their  extraction. 

The  corkscrew  sound  exposes  one  to  the  great 
danger  of  completely  piercing  the  oesophagus,  because 
it  has  to  be  managed  blindly,  and  because  one  never 
knows  at  what  depth  the  corkscrew  portion  should  be 
protruded  in  order  to  obtain  a  proper  bold  of  a  foreign 
body. 

III.  Passage  of  the  probang.     When  taxis  fails  or 

is  inapplicable,  we  are  forced  to  attempt  thrusting  the  foreign  body 
onwards.  The  method  is  much  safer  than  the  preceding,  but,  never- 
theless, demands  great  tact,  prudence,  and  gentleness.  Suitable  oeso- 
phageal sounds  are  made  with  cupped  extremities,  though  in  cases  of 
emergency  an  instrument  can  often  be  successfully  improvised  from  a 
cane,  whip  handle,  or  flexible  stick,  about  4|  to  5  feet  in  length,  securely 
wrapped  at  one  end  with  cloth  or  tow  and  freely  coated  with  some  greasy 
material  such  as  lard,  vaseline,  or  oil. 

The  end  of  the  sound  having  arrived  in  contact  with  the  obstacle, 


I 

Fig.  67.  —  (Eso- 
phageal sounds. 
Probands. 


156  DISEASES   OF   THE   (ESOPHAGUS. 

the  operator  exercises  moderate  but  permanent  pressure.  The  obstacle 
may  not  move  immediately,  because  of  spasm  of  the  oisophagus,  which 
grasps  it.  It  is  therefore  necessary  to  wait  and  to  take  advantage  of  a 
moment  when  the  resistance  is  less,  and  even  then  the  obstacle  may 
not  move. 

Eough  manipulation  with  improvised  sounds  may  tear,  fissure,  or 
perforate  the  muscular  and  mucous  coats,  producing  the  gravest 
consequences. 

IV.  Crushing.  The  crushing  of  an  obstruction  in  the  cervical 
region  was  long  ago  suggested,  and  is  still  greatly  commended  by 
empirics  and  farriers.  It  is  performed  by  means  of  a  little  mallet  and  a 
piece  of  board.  The  method  is  barbarous,  and  exposes  the  animal  to 
such  grave  complications  as  crushing  of  the  oesophageal  walls,  followed  by 
necrosis,  laceration  of  the  connective  tissue,  and  interstitial  hfemorrhage, 
injuries  of  the  superficial  or  deep-seated  jugulars,  of  the  carotid  artery, 
pneumo-gastric  nerve,  etc.  It  should  never  be  practised,  even  although 
attempts  have  been  made  to  improve  it  by  replacing  the  mallet  and  board 
by  sj)ecially  formed  forceps  intended  for  crushing  potatoes  or  roots. 
Only  in  the  rare  cases  where  one  is  certain  that  the  foreign  body  consists 
of  a  very  ripe  fruit  could  crushing  be  justified,  and  in  this  case  there  is  no 
need  to  have  recourse  to  special  instruments,  for  the  hands  alone  suffice. 

Injection  of  alkaloids.  The  practitioner  occasionally  finds  him- 
self in  the  embarrassing  position  of  having  vainly  tried  all  the  above 
methods.  Before  adopting  the  last  resource,  viz.,  oesophagotomy,  it  is 
then  worth  while  to  test  the  action  of  certain  alkaloids,  injected  sub- 
cutaneously,  after  having  punctured  the  rumen. 

We  know  that  pilocarpine  and  eserine  stimulate  secretion  and  the 
action  of  the  bowels.  Injected  under  the  skin  they  cause  frequent 
swallowing  efforts,  and  intense  peristalsis  extending  throughout  the 
length  of  the  digestive  tract.  Doses  of  1|  to  2  grains  of  pilocarpine  and 
1  to  1^  grains  of  eserine,  according  to  the  size  of  the  animal,  scmietimes 
produce  excellent  results,  and  rapidly  remove  obstructions. 

Apomorphine,  the  effects  of  which  are,  so  to  speak,  inverse,  because 
they  tend  to  produce  anti-peristalsis  and  vomiting,  may  l)e  tried  in  doses 
of  2  or  3  grains. 

(Esophagotomy.  The  last  resource  is  cesophagotomy,  which,  how- 
ever, is  only  applicable  in  cases  of  obstruction  of  the  cervical  portion  of 
the  CEsophagus.  It  should  be  performed  as  described  in  the  section  here- 
after on  operative  manipulation.  (See  also  Mdller  and  Dollar's  "Eegional 
Surgery,"  p.  16G.) 

The  point  selected  is  necessarily  governed  by  the  position  of  the 
obstacle.  There  is  no  need  to  enter  into  full  details.  We  may  remark 
that  it  is  not  always  necessary  to  perform  the  complete  operation,  and 


RUPTURES   AND   PERFORATIONS   OF   THE   (ESOPHAGUS.  157 

the  third  and  fourth  stages  can  sometmies  he  avoided  hy  suhstituting  for 
them  attempts  to  hreak  down  the  foreign  body  by  submucous  manipula- 
tion. The  oesophagus,  having  been  exposed  and  isolated,  is  punctured 
with  a  straight  tenotome  immediately  below  the  obstacle.  A  curved 
tenotome  is  then  introduced,  and  the  root,  potato,  or  fruit  divided.  As  a 
rule,  a  little  pressure  from  the  outside  then  causes  one  or  other  of  the 
fragments  to  move  onwards  and  deglutition  becomes  normal. 

Attempts  have  also  been  made  to  divide  the  obstructing  body  directly 
without  previous  incision  and  without  isolating  the  cesophagus.  It  is 
much  more  difficult,  for  the  least  movement  of  the  patient  changes  the 
relationships  of  the  super-posed  layers  and  introduces  obstacles  to  the 
manipulation  of  the  blunt-pointed  tenotome  which  is  employed.  More 
success  often  attends  attempts  to  puncture  the  ol)ject  with  a  fine  trocar. 

RUPTURES    AND    PERFORATIONS    OF    THE    CESOPHAGUS. 

Causation.  Wounds  of  the  oesophagus  caused  l)y  external  violence 
are  rare,  or  at  least  secondary ;  lacerations  produced  from  within,  on 
the  contrary,  as  a  result  of  clumsy  manipulation  are  relatively  frequent. 
They  may  extend  throughout  the  length  of  the  tube,  but  in  a  far  greater 
number  of  cases  are  found  near  the  entrance  to  the  stomach  at  the  point 
where  the  oesophagus  turns  towards  the  left. 

The  passage  of  the  oesophageal  sound  or  probang  is  apt  to  exaggerate 
this  curvature,  and  if  pushed  violently  the  instrument  may  produce  first 
a  flexure,  then  a  partial  rupture  or  even  a  perforation  of  the  tube. 

In  other  cases  a  rough,  irregular,  infected  foreign  body  may  when 
swallowed  penetrate  the  wall  and  cause  inflammation,  necrosis  and 
perforation  of  the  oesophagus. 

The  symptoms  are  always  very  grave,  and  of  rapid  development. 
They  consist  in  local  oedematous  swelling,  sero-sanguineous  infiltration 
at  the  entrance  to  the  chest,  in  the  pretracheal  region  and  along  the 
jugular  furrows. 

The  pneumo-gastric  and  inferior  laryngeal  nerves  being  compressed, 
dyspnoea  results.  If  the  (esophagus  is  perforated  in  the  thoracic  cavity 
septic  pleurisy  at  once  sets  in. 

Diagnosis.  The  diagnosis  is  easy,  provided  the  history  point  to 
perforation  of  the  oesophagus. 

The  prognosis  is  fatal  whenever  the  perforation  is  within  the  thorax. 
It  is  sometimes  possible  to  intervene  in  cases  of  perforation  in  the 
cervical  region,  but  from  the  economic  standpoint  such  intervention  is 
of  Httle  value. 


CHAPTER    IV. 
DEPRAVED    APPETITE-PICA-THE    LICKING    HABIT. 

Depraved  appetite,  causing  animals  to  swallow  l)odies  which  cannot 
pi-opeiiy  be  descrihed  as  food,  is  frequent.  The  condition  is  commonest 
in  adult  animals  of  the  bovine  species,  in  calves  and  in  lambs.  The 
consequences  are  sometimes  very  serious,  so  that  although  depraved 
appetite  does  not  represent  a  well-defined  morbid  entity,  it  is  important 
to  be  in  a  position  to  remedy  it. 

Depraved  appetite  does  not  appear  under  the  same  conditions  in 
young  and  in  old  animals.  In  adults  it  often  results  from  faulty 
feeding,  or  from  some  wasting  disease  which  develops  insidiously,  or 
remains  unrecognised ;  in  young  animals  it  is  the  result  of  insufficient 
nourishment. 

Pioloff  &  Pioll  hold  that  pica  is  the  first  symptom  of  osteomalacia 
(which  see). 

DEPRAVED    APPETITE    IN    THE    OX. 

Causation.  In  the  bovine  species  depraved  appetite  occurs  in  adult, 
debilitated  animals,  which  are  often,  though  not  always,  suffering  from 
some  well-marked  digestive  disturbance. 

The  frequency  of  this  symptom,  and  the  peculiarities  in  its  occur- 
rence, have  caused  it  to  be  referred  to  a  large  number  of  different  causes, 
among  which  may  be  mentioned  bad  hygiene,  chronic  gastro-enteritis, 
tuberculosis,  osseous  cachexia,  pasteurellosis,  gestation,  etc. 

It  is  very  certain  that  the  peculiarity  in  the  appetite  is,  above  all,  the 
result  of  incomplete  and  irrational  alimentation.  The  animal  has  certain 
special  requirements,  to  meet  which  the  food  must  be  of  suitable  compo- 
sition. If  these  alimentary  and  digestive  conditions  are  not  fulfilled, 
depraved  appetite  may  occur,  even  in  animals  which  appear  well 
nourished.  Certain  authors  refer  the  appearance  of  this  condition  to 
want  of  certain  soda  salts  in  the  daily  ration,  and,  in  support  of  this 
opinion,  they  point  to  the  frequency  of  the  disease  in  mountainous 
regions  where  the  geological  formation  is  chiefly  granite,  as  in  the  Black 
Forest.  Alluvial  soils  are  supposed  not  to  produce  it.  It  certainly  seems 
more  common  on  soils  lacking  in  certain  constituents  or  exhausted  by 


DEPRAVED    APPETITE    IN    THE    OX.  159 

repeatedly  growing  certain  crops.  Nevertheless,  in  France  it  might  be 
urged  that  pica  occurs  equally  on  all  kinds  of  soil,  and  a  German  author, 
Lemke,  ascribes  this  perversion  of  nutrition  to  the  want  of  phosphorus. 
Haubner  and  Siedamgrotsky  attribute  it  to  a  nervous  disorder.  All  causes 
which  exhaust  the  organism,  esj)ecially  all  chronic  diseases  of  digestive 
origin,  may  induce  aberration  of  appetite. 

Permanent  stabling,  confinement,  absence  of  sunlight,  want  of  exer- 
cise and  pure  air  contribute  to  the  general  debility  which  predisposes  to 
attack.     Dry  seasons,  by  reducing  the  supply  of  food,  have  a  similar  effect. 

In  tuberculosis  and  in  pasteurellosis,  it  is  the  general  organic  de- 
cline which  produces  these  puzzling  changes  in  appetite.  Similarly 
the  influence  of  gestation  depends  on  the  superadded  demands  on 
the   organism   caused   by   the    development   of   the   fcetus. 

Symptoms.     The  symptoms  may  be  divided  into  two  phases. 

In  the  first  phase,  the  animals  still  preserve  their  appetite,  but 
whenever  they  have  an  opportunity  they  eat  earth,  sand,  manure,  litter 
saturated  with  urine,  plaster,  etc.  They  lick  the  walls,  the  boarding,  the 
mangers  and  the  trees,  and  they  chew  and  swallow  linen  spread  out  to 
dry. 

This  phase  may  continue  for  a  very  long  time,  three  to  four  months 
or  more,  provided  no  acute  complication  results  from  the  eating  of  such 
foreign  material.  There  is  no  fever,  but  the  aj^petite,  although  well 
preserved,  is  often  capricious,  and  the  ordinary  food  is  eaten  slowly. 

In  the  second  phase,  which  frequently  marks  the  development  of 
complications  produced  by  the  passage,  contact,  or  prolonged  sojourn  of 
various  materials  in  the  digestive  tract,  fever  appears,  little  marked  as  a 
rule,  but  continuous  in  character. 

The  appetite  is  dimhiished.  The  animal  wastes  ;  the  secretion  of 
milk  diminishes,  and  signs  of  chronic  gastro-enteritis  may  be  noted.  The 
perversion  of  appetite  still  continues ;  rags,  decomposing  or  filthy 
materials,  pieces  of  old  shoes,  etc.,  are  eaten,  and  it  is  not  surprising 
that  such  substances  should  have  an  unfavourable  effect  on  the  mucous 
membrane  of  the  digestive  tract. 

The  Agisting  process  slowly  leads  to  marked  emaciation,  and  after  an 
interval  of  from  six  months  to  a  year,  or  even  two  years,  the  patients 
die  in  a  state  of  complete  exhaustion.  The  lesions  found  on  post-mortem 
examination  are  those  of  various  diseases  capable  of  producing  depraved 
appetite  or  simply  lesions  of  chronic  gastro-enteritis. 

Diagnosis.  The  diagnosis  presents  no  difficulty.  The  important 
point  is  to  discover  whether  or  not  there  exists  some  previously  un- 
recognised primary  disease. 

Prognosis.  The  prognosis  of  this  condition  is  grave,  because  de- 
praved appetite  is  frequently  only  a  symptom  of  some  incurable  disorder, 


160  DEPRAVJ'^D   APPETITE — PICA — THE   LICKING   HARIT. 

or  because  the  changes  in  the  digestive  mucous  nieml)rane  are  ah-eady 
too  far  advanced  to  permit  of  much  improvement. 

The  lesions  comprise :  general  emaciation,  presence  of  a  yellow 
serum  in  the  fatty  tissue,  muscles  pale  and  flabby,  catarrh  of  the 
mucous  membrane  of  the  stomach  and  bowel.  The  blood  seems  less  in 
quantity  and  coagulates  feebly  or  not  at  all. 

Treatment.  The  treatment  should  be  directed  against  the  primary 
cause,  if  such  exists  (osseous  cachexia,  pasteurellosis,  gestation,  etc.). 

In  other  cases  a  change  in  management  and  in  feeding,  and  the 
administration  of  food  rich  in  mineral  salts  like  chlorides,  carbonates,  and 
phosphates  of  lime,  soda  or  potash,  produces  the  best  possible  results. 
The  leguminous  foods,  sainfoin,  clover  and  lucern,  are  to  be  recommended. 
The  animal,  if  formerly  stabled,  should  be  turned  out  and  its  living  con- 
ditions entirely  altered. 

It  is  often  useful  to  place  a  block  of  rock  salt  in  the  manger ;  when 
hyperacidity  of  the  stomach  is  suspected  lime  water,  chalk,  or  magnesia 
should  be  given.  Where  digestion  is  weak  or  slow  HCl,  pepsin  and 
vegetable  bitters  are  indicated.  Nevertheless,  one  sees  cases  which  refuse 
to  yield  to  any  of  the  ordinary  methods.  In  treating  these,  Lemke  has 
recommended  the  subcutaneous  injection  of  chloride  of  apomorphine,  a 
drug  which  may  be  regarded  as  a  true  specific.  The  doses  vary  between 
1^,  and  3  grains,  and  an  injection  is  given  once  a  week  for  three  weeks  in 
succession.  After  this  the  tendency  to  pica  is  said  to  disappear  and  the 
general  condition  to  improve.  The  treatment  must  be  repeated  every 
three  months  in  countries  where  depraved  appetite  appears  general  and 
permanent. 

It  is  difficult  to  understand  by  what  mechanism  this  drug  produces 
the  effects  attributed  to  it,  but  those  who  have  employed  it  speak  very 
highly  of  its  action. 

We  may  add  that  in  addition  to  the  different  modes  of  treatment,  it  is 
not  infrequently  necessary  to  hastily  perform  gastrotomy  in  order  to 
avoid  fatal  consequences,  which  would  otherwise  follow  indulgence  in 
this  habit.  When  an  animal  has  swallowed  a  considerable  quantity  of 
linen,  for  example  (and  Moussu  has  seen  cases  in  which  many  pounds 
weight  had  been  devoured),  immediate  intervention  is  required  to  avoid 
intestinal  obstruction.  Furthermore,  when  the  history  is  quite  clear 
gastrotomy  allows  the  entire  mass  of  foreign  bodies,  ingested  at  different 
times,  to  be  removed. 

DEPRAVED    APPETITE    IN    CALVES    AND    LAMBS. 

Causation.  Depraved  appetite  is  commonest  in  calves  and  lambs 
when  the  animals  are  insufficiently  nourishexl,  or  when  the  mothers  are 
suffering  from  chronic  debilitating   diseases  and  are  therefore  yielding 


DEPRAVED   APPETITE   IN   CALVES   AND   LAMBS.  161 

milk  poor  in  fat  and  in  mineral  constituents.  In  a  few  rare  cases  it  is 
impossible  to  discover  what  causes  the  young  animals  to  devour  these 
foreign  materials.  Even  fally-grown  sheep,  when  shut  up  together  in 
winter,  acquire  the  habit  of  chewing  each  other's  wool,  sometimes  to 
the  extent  of  virtually  depilating  their  fellows  and  accumulating  wool 
balls  in  their  stomachs. 

Symptoms.  Calves  have  a  tendency  to  lick  themselves  or  their 
neighbours,  and  thus  little  by  little  collect  a  varying  quantity  of  hair 
which  they  swallow.  When  this  habit  of  licking  is  little  marked  the 
quantity  of  hair  ingested  may  not  be  dangerous ;  but  in  the  contrary 
case  the  hair  (which  cannot  be  digested)  accumulates  and  is  permanently 
retained  in  the  abomasum.  It  soon  becomes  converted  into  masses, 
cemented  together  with  mucus,  and  forms  round  balls,  to  which  the  name 
of  oegagrophiles  has  been  given.  If  these  cegagrophiles,  or  hair  balls,  are 
of  small  size,  they  prove  of  trifling  importance  ;  but  too  frequently  they 
attain  considerable  dimensions  and  obstruct  the  pylorus  or  the  intestine. 
The  young  calves  then  refuse  all  nourishment,  and  die  in  twenty-four  to 
forty-eight  hours  in  a  state  of  complete  exhaustion  or  after  a  series  of 
epileptiform  attacks. 

In  lambs  the  complications  due  to  depraved  appetite  develop  in  a 
similar  way,  but  the  wool  swallowed  is  obtained  from  the  mothers.  The 
lauibs  first  suck  the  locks  of  wool,  then  tear  them  off  and  swallow  them. 
So  long  as  these  peculiarities  of  appetite  are  little  marked  no  bad  results 
follow  ;  but  if  the  shepherd  is  careless,  and  fails  to  note  the  condition  of 
his  young  flock  sufficiently  early,  accidents  occur. 

The  wool  is  not  so  easily  converted  into  balls  as  is  hair,  but  it  soon 
accumulates  in  the  pyloric  region  or  in  the  intestine,  and  forms  obstruct- 
ing masses.  The  little  patients  lose  appetite  and  lie  down  in  corners, 
where  they  are  found  dead  after  twenty-four  to  forty-eight  hours.  The 
masses  of  wool  or  of  hair  are  rarely  passed  with  the  excrement ;  more 
frequently  they  are  vomited,  but  this  again  is  exceptional;  usually  they" 
become  arrested  at  the  entrance  to  the  pylorus.  The  lambs  show  colic, 
tympanites  of  the  abomasum,  and  attempts  at  vomiting,  though  unfor- 
tunately these  are  often  overlooked.  The  quantity  of  wool  found  in  the 
abomasum  and  intestine  on  post-mortem  examination  may  be  consider- 
able, in  relation  to  the  size  of  the  digestive  compartments.  Death  results 
from  intestinal  obstruction,  exactly  as  in  the  case  of  calves. 

These  aberrations  of  appetite  in  lambs  have  been  considered  as  due 
to  the  want  of  sufficient  mineral  salts  in  the  mother's  milk  ;  and  it  has 
been  stated  that  the  lambs  practise  this  habit  because  of  the  laxative 
result  of  the  fat  contained  in  the  wool  swallowed.  The  explanation  seems 
very  logical,  though  it  is  by  no  means  perfectly  proved.  It  is  certain  that 
this  habit  becomes  particularly  common  after  years  in  which  forage  has 

D.C.  M 


162  COLIC. 

been  scarce  and  among  flocks  in  bad  bodily  condition.  The  force  of 
example  also  plays  a  certain  part,  and  animals  probably  imitate  one 
another,  and  so  acquire  the  disease.  This  explains  the  importance  of 
early  segregation. 

Diagnosis.  The  diagnosis  of  depraved  appetite,  pica,  or  the  licking 
habit  presents  no  difficulty ;  but  it  can  only  be  arrived  at  by  the  cow- 
man or  shepherd,  for  the  symptoms  can  only  be  detected  by  continued 
watching. 

The  diagnosis  of  pyloric  or  intestinal  obstruction  is  very  difficult  in 
the  absence  of  information.  It  becomes  easy  after  the  first  post-mortem 
examination  has  been  made. 

Prognosis.  The  prognosis  is  grave.  In  calves,  obstruction  of  the 
bowel  by  hair-balls  inevitably  causes  death,  and  in  sucking  lambs  the 
mortality  may  be  high  :  as  much  as  15  per  cent,  to  20  per  cent,  according 
to  the  observations  of  several  observers.  The  mortality  occurs  about 
the  age  of  six  weeks  to  two  months,  whilst  the  licking  habit  may  begin 
towards  the  end  of  the  second  week. 

Treatment.  Prophylaxis  demands  that  the  mothers  (whether  cows 
or  ewes)  be  well  fed.  An  excellent  precaution  consists  in  adding  to  the 
food  a  sufficient  quantity  of  salt  and  of  phosphate  of  lime  (2  drams 
to  2^  drams  of  each).  This  treatment  of  the  mothers  is  necessary 
as  soon  as  the  tendency  to  licking  becomes  manifest. 

In  calves  the  best  method  of  avoiding  fatal  results  is  to  prevent  the 
young  animals  licking  one  another ;  and  the  method  now  usually  prac- 
tised on  well-managed  farms  consists  in  applying  a  simple  muzzle  of 
wicker  work  immediately  after  each  meal. 

In  lambs  treatment  is  more  difficult.  As  soon  as  the  shepherd 
sees  any  tendency  to  depraved  appetite  the  lambs  should  only  be  left 
with  their  mothers  whilst  being  suckled.  The  flock  should  be  exercised 
in  the  open,  and  ordinary  salt  should  be  placed  at  a  number  of  points  on 
'the  ground  occupied  by  the  animals. 

COLIC    IN    THE    OX. 

COLIC    DUE    TO    INGESTION    OF    COLD    WATER.       CONGESTIVE    COLIC. 

Causation.  Congestive  colic  occurs  in  the  stable,  in  animals  which 
have  been  doing  heavy  work,  and,  returning  in  a  heated  condition,  drink 
large  quantities  of  cold  water.  It  is  commoner  when  animals  have  not 
eaten  for  a  considerable  time,  and  when,  therefore,  the  stomach  is  nearly 
empty.  Under  these  circumstances  chill  of  the  digestive  viscera  is  direct 
and  immediate. 

Symptoms.  This  form  of  colic  occurs  suddenly,  soon  after  the  water 
has  been  swallowed,  and  is  characterised  by  violent  pain.     At  first  the 


COLIC   DUE   TO   INGESTION   OF   COLD   WATER — CONGESTIVE   COLIC.      163 

animals  show  uneasiness,  stamp,  and  continually  move  about  striking 
themselves  in  the  flank  with  the  feet  or  horns,  swishing  the  tail,  etc. 
They  refuse  food,  lie  down  and  rise  frequently,  and  paw  the  ground. 

As  a  general  rule  this  form  of  colic  lasts  from  half  an  hour  to  one 
hour,  and  terminates  in  recovery.  In  some  rare  cases  where  death 
occurred  Cruzel  found  on  post-mortem  examination  congestion  of  the 
abomasum,  and,  in  a  few,  congestion  of  the  small  intestine,  with  or 
without  rupture. 

The  diagnosis  is  easy,  on  account  of  the  suddenness  of  onset,  rapid 
development  and  history  of  the  disease,  discovered  on  questioning  the 
owner  or  herdsman. 

The  prognosis  is  not  grave.  This  form  of  colic  generally  cures  itself. 
Nevertheless  precautions  are  required  against  possible  complications, 
such  as  intestinal  hfemorrhage  and  invagination. 

The  necessary  preventive  measures  are  self-evident.  Animals  return- 
ing from  work  should  not  be  allowed  to  drink  freely  of  cold  water,  but 
should  first  receive  a  little  food  and  afterwards  water  at  the  temperature 
of  the  atmosphere. 

When  colic  has  set  in,  the  patient  can  be  walked  about.  If  pain 
persists,  the  region  of  the  abdomen  may  be  dressed  with  oil  of  turpen- 
tine, mustard,  or  similar  counter-irritants.  The  application  of  warm 
clothing  is  also  useful.  Finally,  in  grave  cases,  a  moderate  quantity 
(three,  four,  or  five  quarts)  of  blood  maybe  withdrawn  from  the  jugular. 
The  administration  of  stimulants  like  wine,  alcohol,  etc.,  is  also 
indicated. 

COLIC    DUE    TO    INVAGINATION. 

Invagination  consists  in  the  passage  of  one  portion  of  the  intestine 
into  the  next-following  portion.  "When  once  the  condition  has  been  set 
up  it  tends  to  become  aggravated,  the  invaginated  part  being  drawn 
further  and  further  forwards.  Invaginations  therefore  may  vary  in 
length  between  a  few  inches  and  sixteen  to  twenty  inches. 

Law  states  (Vol.  II.  p.  347)  that  in  cattle  and  swine  invagination  of 
the  large  colon  is  almost  impossible  owing  to  the  relation  of  the  bowel 
with  the  layers  of  the  mesentery.  The  anatomical  arrangement  is 
opposed  to  the  formation  of  invagination,  yet  this  accident  is  not 
uncommon  in  cattle  and  swine.  The  small  intestine  can  be  invaginated 
into  the  caecum  or  into  itself.  The  caecum  may  become  invaginated,  or 
it  may  pass  into  the  colon  or  rectum. 

Cartwright,  Veterinarian  (1829),  reports  a  case  of  invagination  in 
a  bull  calf,  and  Youatt  gives  particulars  of  a  similar  case  which  was 
followed  by  sloughing  and  discharge  per  anum  of  the  intussuscepted 
portion  of  bowel.  (See  also  Moller  and  Dollar's  "  Eegional  Surgery," 
p.  328.) 

M  2 


164  COLIC. 

Causation.  This  variety  of  colic  is  due  to  a  number  of  somewhat 
obscure  causes.  In  a  general  sense  we  may  say  that  anything  which 
increases  intestinal  peristalsis  increases  the  risk  of  invagination.  The 
accident  may  follow  intestinal  congestion,  but  is  most  frequent  in 
animals  suffering  from  intestinal  worms,  or  in  animals  used  for  heavy 
work.  Under  the  influence  of  violent  tractive  efforts  the  peristaltic 
movements   are    stimulated,    and    the    intestine    being    in    an    oblique 


--%1^ 


Fig 


68. — Invagination  of  tlie  intestine  in  an  ox  (the  constricting  portion  has 
been  incised  longitudinally). 


position  on  a  plane  inclined  backwards,  the  contracted  portion  may  slip 
into  the  dilated  section  behind  it. 

Invagination  may  also  occur  without  any  apparent  cause,  even  in 
animals  standing  in  the  stable. 

Symptoms.  The  attack  always  occurs  suddenly,  develops  rapidly, 
and  is  of  an  extremely  grave  character. 

Colic  conies  on  while  the  animal  is  working,  moving  about,  or  resting, 
according  to  circumstances,  and  at  first  resembles  that  due  to  congestion. 
It  afterwards  becomes  very  violent ;  the  animals  paw,  stamp,  show  great 
uneasiness,  throw  themselves  violently  down,  and  rise  suddenly,  only  to 
again  lie  down  as  before.  The  face  expresses  anxiety,  suffering  and 
depression  ;  the  tail  is  often  kept  lifted,  and  efforts  are  continually  made 
to  deffecate,  mucus  being  passed.  By  passing  the  hand  into  the  rectum 
the  invagination  may  occasionally  be  discovered. 


COLIC    DUE   TO    INVAGINATION.  165 

Colic  persists  with  great  intensity  for  ten  to  twelve  hours,. interrupted 
only  by  rare  periods  of  calm.  At  the  end  of  this  time,  however,  it  may 
suddenly  disappear,  and  the  animal  may  fall  into  a  semi-comatose  state. 
This  indicates  the  onset  of  necrosis  in  the  invaginated  section,  the  painful 
reflexes  no  longer  being  transmitted  to  the  sympathetic  system.  The 
disappearance  of  colic  is  sometimes  regarded  as  a  sign  of  improvement, 
but  this  improvement  is  illusory.  From  this  time  onwards  the  animals 
stand  stolidly,  obstinately  refusing  both  food  and  drink.  If  they  lie  down, 
it  is  with  great  care.  Palpation  of  the  right  side  of  the  abdomen  is 
painful,  and  the  animal  actively  resents  it.  One  of  the  most  important 
and  constant  signs  at  this  stage  is  the  absence  of  defaecation,  due  to  ob- 
struction of  the  intestine,  which  is  occluded.  The  animals  may  survive 
for  ten,  twelve,  or  even  fifteen  days  (see  also  Moller  and  Dollar's 
"Regional  Surgery,"  loc.  cit.).  The  invaginated,  necrosed  portion  may 
even  be  passed  with  the  fieces,  and  recovery  may  occur,  the  continuity  of 
the  intestinal  tube  being  secured  by  the  adhesion  of  the  serous  surfaces  ; 
l)ut  such  spontaneous  recoveries  are  exceptional.  Usually  after  a  few 
days  death  results  from  peritonitis. 

Occasionally,  trifling  invaginations  may  become  reduced  spontaneously. 
Diarrhoea,  with  the  passage  of  blood-stained  material  is  then  seen  for  a 
time,  a  sign  which  alone  at  this  stage  would  justify  the  diagnosis  of 
invagination. 

Diagnosis.  The  intensity  of  the  colic  and  the  absence  of  defeca- 
tion for  several  days  afterwards,  justifies  the  diagnosis  of  invagination. 
Purgatives  then  remain  without  effect.  In  addition,  rectal  exploration 
offers  a  valuable  means  of  diagnosis.  The  last  portions  of  the  intestine 
are  found  absolutely  empty,  and  the  arm  when  withdrawn  is  found  to 
be  covered  with  viscous  blood-stained  mucus,  resulting  from  the  sero- 
sanguinolent  exudate,  due  to  compression  of  the  blood-vessels. 

In  cases  of  this  kind  accompanied  by  the  above-mentioned  symptoms 
abdominal  exploration  by  the  rectum  should  always  be  practised,  but  it 
rarely  gives  exact  information.  The  hand,  when  passed  towards  the 
right  flank,  may  sometimes  reach  the  invaginated  part,  which  conveys  the 
impression  of  a  cylindrical  swelling.  The  invagination,  however,  can 
rarely  be  reached.  If  the  operator  is  successful,  he  will  find  that  as  he 
displaces  this  cylindrical  mass  or  attempts  to  grasp  it,  the  animal  shows 
signs  of  exaggerated  sensitiveness. 

The  prognosis  is  of  exceptional  gravity.  Apart  from  the  rare  cases 
where  the  invaginated  portion  becomes  necrotic  and  is  eliminated,  death 
is  inevitable.  Unless  an  operation  is  performed,  septic  peritonitis  may 
develop  about  the  fifth  or  sixth  day. 

Treatment.  The  only  treatment  consists  in  surgical  intervention. 
Some  practitioners  have  recommended  giving  large  doses  of  purgatives 


166  COLIC. 

with  the  idea  of  causing  changes  in  the  neighhourhood  of  the  invaginated 
part ;  hut  such  treatment  presents  Httle  chance  of  success.  The  same  is 
true  of  the  administration  of  hirge  doses  of  ohve  oil,  either  in  the  form  of 
draught  or  of  enema. 

Siehert  attemi^ted  reduction  hy  generating  CO2  from  soda  hicarho- 
nate  dissolved  in  water  and  diluted  HCl,  injected  .successively  per 
rectum.  In  time  ffeces  and  CO2  escaped,  and  the  patient  recovered. 
Siehert  claims  to  have  cured  hy  this  method  a  cow  with  invagination  of 
five  days'  duration ;  hut  the  effect  of  his  treatment  may  he  douhted,  as 
afterwards  a  portion  of  howel  was  found  in  the  cow's  dung. 

When  diagnosis  is  certain,  the  only  treatment  that  can  he  recom- 
mended consists  in  performing  laparotomy  followed  hy  enterotomy. 
One  cannot,  however,  operate  in  all  cases,  nor  do  all  cases  offer  the  same 
chances  of  success.  If  the  invagination  is  situated  in  the  first  portion 
of  the  small  intestine,  and  is  hidden  beneath  the  circle  of  the  hypo- 
chondrium,  intervention  is  out  of  the  question,  but  if  it  has  been 
detected  by  rectal  exploration  in  the  last  portion  of  the  intestine, 
operation  may  prove  successful.  Only  in  cases  of  the  latter  description 
should  it  be  attempted. 

Laparotomy  is  performed  in  the  right  flank  according  to  the  usual 
method  (see  MoUer  and  Dollar's  "Regional  Surgery,"  p.  313).  After 
opening  the  peritoneal  cavity,  the  invaginated  loop  of  intestine  must  be 
sought.  It  is  not  always  easy  to  discover  amongst  the  mass  of  intestines 
present,  but  can  be  recognised  by  its  hardness  and  by  the  congestion 
of  neighbouring  parts.  After  withdrawing  it  through  the  abdominal 
opening,  the  operator  may  then  proceed  by  one  of  several  methods. 

(1.)  Some  authors  recommend  grasping  the  two  ends,  drawing  them 
apart,  and  thus  reducing  the  invagination.  The  actual  manoeuvre  is 
not  difficult,  but  even  when  unattended  by  accident  or  tearing  of  the  in- 
testine it  is  by  no  means  always  followed  by  recovery.  Although  the 
intestine  may  not  appear  gangrenous  externally,  necrosis  often  occurs 
eventually. 

This  method  should  only  be  practised  during  the  first  twenty-four 
hours  after  the  appearance  of  colic,  and  even  then  one  must  always  bear 
in  mind  the  possible  consequences  just  mentioned,  and  the  chances  of 
rapidly  fatal  septic  peritonitis. 

.  (2.)  The  second  method  consists  in  removing  the  invaginated  portion 
of  intestine.  It  is  best  to  apply  bichromatised  catgut  or  silk  ligatures 
to  all  the  arteries  which  pass  from  the  mesentery  into  the  loop  to  be  re- 
moved ;  after  which  the  loop  itself  may  be  simply  divided  an  inch  or  two 
above  and  below  the  invagination,  in  order  to  be  quite  certain  that  one  is 
operating  on  healthy  tissue,  the  divided  ends  being  held  meanwhile  by 
an  assistant.     The  intestine  is  afterwards  sutured  with  a  fine  needle  and 


COLIC    AS   A    RESULT   OF   STRANGULATION.  167 

bichromatised  catgut  or  boiled  silk.  The  form  of  suture  will  be  found 
described  in  Dollar's  "  Operative  Technique."  It  may  be  valuable  to  test 
the  efficacy  of  decalcified  bone  tubes  for  uniting  the  ends  of  the  intestine. 

The  operation  is  long,  delicate  and  difficult,  and  it  is  imperative  not 
to  infect  the  abdominal  cavity  during  its  performance.  To  prevent  this 
the  liquid  and  solid  materials  present  in  the  bowel  may  be  thrust  upwards 
and  downwards  away  from  the  diseased  part  before  the  section  is  made  ; 
and  in  this  way  the  wound  and  the  operator's  hands  are  preserved  from 
infection.  The  intestine  should  be  kept  closed  during  the  application  of 
sutures  by  means  of  flat  clamps  cautiously  applied.  In  their  absence  the 
ends  may  be  held  by  an  assistant,  whose  hands  should  previously  have 
been  carefully  disinfected. 

(3.)  In  cases  where  the  serous  coats  of  the  two  portions  of  bowel  con- 
stituting the  invagination  are  to  some  extent  adherent,  another  opera- 
tion of  a  less  perilous  character  may  be  performed.  This  consists  in 
liberating  the  invaginated  part  by  means  of  longitudinal  incision,  without 
previously  disengaging  the  parts,  and  without  resection.  The  invagi- 
nated (external)  portion  of  intestine  is  divided  longitudinally ;  the  gan- 
grenous part  immediately  becomes  visible,  and  may  be  removed.  The 
operator  has  then  only  to  suture  the  longitudinal  wound,  an  operation 
which  is  much  easier  and  demands  much  less  time  than  any  circular 
intestinal  suture  whatever.  These  operations  must  not  be  attempted 
except  in  response  to  the  express  wish  of  the  owner,  who  should  be  fully 
informed  of  the  dangers  to  which  they  expose  the  animal ;  for  after 
the  second  day  of  invagination  local  peritonitis  has  often  developed 
and  one  is  then  operating  on  injured  or  infected  tissues,  in  itself  a 
very  unfavourable  modifying  condition.  The  current  formula  that  "  the 
operation  was  very  successful "  is  not  accepted  in  veterinary  practice 
when  the  patient  dies  three  or  four  days  afterwards.  From  the  eco- 
nomic standpoint  it  is  better  to  slaughter  animals  of  any  value,  for 
unless  secondary  peritonitis  has  occurred,  and  the  animal  is  not  feverish, 
the  meat  is  fit  for  consumption.  "  Volvulus,"  or  twist  of  the  intestine, 
is  said  to  be  almost  unknown  in  cattle,  though  Eeichert  records  a  case  of 
volvulus  of  the  ileum. 

COLIC    AS    A    RESULT    OF    STRANGULATION. 

The  symptoms  of  this  colic  dift'er  very  little  from  those  of  the  preceding 
with  which  they  are  often  confused.  But  in  regard  to  its  causation  the 
condition  is  essentially  different. 

Causation.  Strangulation  of  the  intestine  in  the  ox  may  be  produced 
in  several  different  ways  :  by  the  passage  of  a  loop  of  intestine  through 
a  tear  in  the  epiploon,  through  the  diaphragm,  mesenteiy,  broad  liga- 
ment of  the  uterus,  the  serous  layer  surrounding  the  spermatic  cord,  etc., 


168 


or  by  strangulation  of  an  intestinal  loop  by  fibrous  bands  resulting 
from  chronic  jjeritonitis,  etc.  Of  these  various  causes,  the  three  prin- 
cipal may  here  be  described : — 

(1.)  Tearing  of  the  mesentery.  As  a  result  of  mechanical  violence 
the  ej)iploon  or  mesentery  becomes  fissured,  and  the  peristaltic  move- 
ments cause  a  loop  of  intestine  to  pass  through  and  become  fixed  in 
the  fissure.  If  the  opening  is  narrow,  as  is  usually  the  case,  the  base 
of  the  intestinal  loop,  riding  on  the  lower  lip  of  the  slit,  becomes  con- 
stricted by  the  margins  of  the  ojjening  through  which  it  has  passed. 

(2.)  In  pelvic  hernia  a  loop  of  intestine  passes  between  the  spermatic 
cord  and  the  walls  of  the  pelvis.  The  fissure  in  this  case  is  in  the 
serous  fold  which  supports  the  large  testicular  arteries  and  the  vas 
deferens.     The  fold  is  often  ruptured  during  castration,  especially  during 

the  practice  of  "  bistournage,"  in  conse- 
quence of  traction  exercised  on  the  cord. 

(3.)    Pseudo  -  ligaments    and    fibrous 
bands    due    to    chronic    i^eritonitis. — In 
local,  sul.)acute  or  chronic  peritonitis  false 
membranes  may  become  organised,  form- 
ing fibrous  cords  or  folds  connecting  the 
parieto-visceral.or  inter-visceral  surfaces. 
If  by  accident  a  loop  of  intestine  insinu- 
ates itself  beneath  one  of   these  fibrous 
bands,  the  passage  of  digestive  material 
is  first  impeded  and  then  stopped.     The 
intestine  becomes   engorged,  and   symp- 
toms of  strangulation  soon  folloM'. 
The  symptoms  appear  suddenly,  and  are  similar  to  those  of  inva- 
gination.    They  consist  of  very  acute  colic,  which  disappears  after  ten 
to  twelve  hours. 

The  peristaltic  movements  drive  the  semi-digested  food,  whether  liquid 
or  gaseous,  towards  the  lower  (strangulated)  end,  from  which  it  cannot 
escape.  It  therefore  distends  the  herniated  loop  and  sets  up  intestinal 
engorgement.  This  constitutes  the  first  stage  of  strangulation,  and  is 
accompanied  by  severe  disturbance  in  the  local  circulation.  The  nuicous 
membrane  of  the  intestine  becomes  swollen  and  infiltrated,  so  that  it 
alone  soon  fills  the  entire  neck  of  the  hernia.  Necrosis  of  the  loop  of 
intestine  is  then  only  a  matter  of  time. 

The  diagnosis  of  colic  l)y  strangulation  is  difficult.  The  condition 
cannot  often  l)e  recognised  at  an  early  stage,  and  may  easily  and 
excusably  be  confused  with  invagination.  Only  in  rare  cases  will  rectal 
and  abdominal  examination  enable  one  to  detect  a  pelvic  or  mesenteric 
hernia. 


Fig.  69. — Schema  of  hernial 
strangulation. 


DISEASES   OF   THE    STOMACH.  169 

The  prognosis  is  even  graver  than  in  cases  of  invagination.  Intes- 
tinal hernia  progresses  very  rapidly,  necrosis  soon  sets  in,  and  is 
followed  by  fatal  consequences  if  the  condition  be  not  relieved. 

The  treatment  is  exclusively  surgical.  As  a  general  rule,  whenever 
colic  is  recognised  as  resulting  from  strangulated  hernia,  it  is  imme- 
diately necessary  to  perform  laparotomy  in  the  right  flank,  and  after 
having  discovered  the  cause  of  strangulation,  to  divide  the  mesentery, 
epiploon,  serous  fold  supporting  the  testicular  cord,  or  accidental  fibrous 
bands,  so  as  to  free  the  herniated  loop  and  avoid  necrosis.  If  necrosis 
already  exist,  the  intestine  may  be  resected,  exactly  as  in  invagination. 

DISEASES    OF    THE    STOMACH. 

In  ruminants  diseases  of  the  gastric  compartments  are  numerous, 
and,  although  they  have  been  recognised  since  the  earliest  times,  much 
remains  to  be  discovered  concerning  at  least  some  of  them.  This  fact 
results  from  the  imperfect  state  of  our  knowledge  concerning  the  essential 
phenomena  of  gastric  digestion  in  ruminants.  Digestion  really  consists 
of  a  number  of  different  acts — some  mechanical  or  neuro-motor,  some 
chemical ;  in  addition  to  which  must  be  reckoned  the  phenomena  of 
sensation,  concerning  which  patients  cannot  give  any  information. 

The  mechanical  phenomena,  consisting  in  the  constant  movement 
of  ingested  material  through  the  different  compartments,  rumination, 
eructation,  evacuation  towards  the  intestine,  etc.,  are  well  known  to  us; 
and  a  careful  examination  of  diseased  animals  enables  us  to  estimate  the 
importance  of  changes  in  them. 

On  the  other  hand,  the  chemical  phenomena  are  little  understood. 
It  has  hitherto  been  considered  that  the  rumen,  reticulum,  and  omasum 
are  only  simple  diverticula,  with  mechanical  functions,  and  that  the 
abomasum  is  the  reservoir  in  which  the  chemical  changes  take  place. 
Another  view,  which  is  perhaps  not  altogether  justified,  presupposes 
that  the  chemical  transformation  of  the  food  in  the  abomasum  takes 
place  as  in  other  animals,  and  in  particular  as  in  man,  in  whom  the 
chemistry  of  gastric  digestion  has  been  the  object  of  extremely  careful 
research  by  certain  French  and  other  pathologists.  We  do  not  believe 
(for  reasons  too  long  to  be  explained  here)  that  the  gastric  digestion  of 
ruminants,  or  even  of  herbivora  in  general,  can  be  identified  with  that 
of  omnivora. 

The  nature  of  the  food  being  totally  different,  the  chemical  reactions 
in  the  stomach  and  intestines  are  also  different ;  in  proof  of  which  we 
need  only  cite  the  single  fact  that  ptyalin  is  absent  from  the  saliva. 
Straw  and  oats  are  not  digested    in  the  same  way  as  a  mutton  cutlet. 

But  even  supposing  that  the  broad  outlines  of  physiological  action 


170  INDIGESTION. 

are  the  same,  nothing  has  hitherto  heen  discovered  in  veterinary  surgery 
respecting  possible  variations  in  the  chemical  processes  taking  place  in 
the  stomach  during  different  gastric  diseases ;  and  it  appears  not  impro- 
bable that  in  this  direction  causes  might  be  discovered  which  veterinary 
practitioners  have  hitherto  sought  elsewhere.  Excess  or  insufficiency  of 
hydrochloric  acid,  and  variations  in  the  quantity  of  the  organic  acids,  play 
so  important  a  part  in  the  theory  of  gastric  pathology  in  man,  that  it  is 
scarcely  surprising  to  find  similar  ideas  recurring  in  the  pathology  of 
domestic  animals.  The  correctness  of  these  views  remains  to  be  proved ; 
and  without  wishing  actually  to  classify  dyspeptic  conditions  as  in  man, 
we  may  assert  that  diseases  described  under  other  names  stand  in  direct 
relation  to  variations  in  the  gastric  secretion  or  to  disturbance  of  gastric 
movements — e.g.,  simple  chronic  tympanites,  which,  without  a  doubt,  is 
often  a  neuro-motor  dyspepsia. 

The  classification  we  shall  adopt  in  studying  the  diseases  of  the 
gastric  compartments  is,  therefore,  extremely  simple.  In  the  first 
series  we  shall  consider  sudden,  accidental,  and  temporary  forms  of 
indigestion,  and  in  the  second  series,  acute  or  chronic  forms  of  gastric 
inflammation. 

INDIGESTION. 

GASEOUS    INDIGESTION. 

Gaseous  indigestion,  also  described  as  indigestion  of  the  rumen,  is 
characterised  by  the  rapid  accumulation  of  gases  (chiefly  carbon  dioxide, 
carbon  monoxide,  and  marsh  gas),  due  to  fermentation  in  the  upper 
part  of  the  rumen.  It  is  common  in  oxen  and  sheep,  and  has  received 
the  names  of  mephitic  indigestion,  acute  tympanites,  meteorism,  etc. 
It  occurs  during  or  immediately  after  feeding. 

Causation.  Numerous  causes  have  been  invoked  to  explain  the 
sudden  occurrence  of  gaseous  indigestion. 

The  most  important  is  the  particular  condition  of  the  animal  at  the 
moment  when  it  has  been  attacked.  For  if  external  influences  alone 
were  responsible,  there  is  no  reason  why  all  the  animals  of  a  given  herd 
or  flock,  or  of  a  particular  stable,  which  are  under  similar  conditions 
as  regards  feeding,  etc.,  should  not  be  affected  in  the  same  way. 

That  the  external  causes  cited  (cold,  excessive  heat,  stormy  weather, 
etc.)  may  afi"ect  different  animals  differently  and  unfavourably  is  beyond 
doubt.  But  the  temporary  morbid  condition  of  the  animal  itself  is  the 
essential  condition  to  the  development  of  indigestion. 

In  all  probability  the  animal  has  in  every  case  been  more  or  less 
unwell,  except  in  those  attacks  of  indigestion  resulting  from  progressive 
poisoning  during  the  course  of  a  meal,  such  as  occur  when  toxic  plants 


GASEOUS   INDIGESTION.  171 

like  belladonna,  veratrine,  colchiciim,  poppies,  tobacco,  hemlock,  etc., 
have  been  eaten.  In  such  temporary  abnormal  states  movement  of  the 
rmnen  is  partly  abolished,  or  at  least  is  markedly  retarded,  and,  as  a 
consequence  of  vaso-motor  disturbance,  the  mucous  membrane  is  pro- 
bably not  so  abundantly  covered  with  mucus  nor  so  freely  irrigated  with 
secretion,  as  usual.  Under  these  conditions,  if  the  animal,  which  may 
appear  perfectly  well,  is  allowed  to  partake  of  soft,  wet,  fermentescible 
food,  gaseous  indigestion  is  very  likely  to  develop. 

Cultivated  grasses,  like  lucern,  sainfoin,  clover,  and  especially  grasses 
grown  on  artificially  manured  fields,  are  regarded  as  particularly  liable 
to  cause  gaseous  indigestion.  This  conclusion  seems  justified  by  expe- 
rience, particularly  by  the  fact  that  young  shoots  or  young,  tender 
after-growths  are  very  liable  to  fermentation. 

This  exaggerated  tendency  to  fermentation  of  tender  grasses  has  even 
been  held  exclusively  responsible  for  indigestion,  and  the  cessation  of 
peristalsis  in  the  rumen  has  been  considered  a  secondary  phenomenon, 
due  to  distension. 

Whether  atony  of  the  rumen  be  the  primary  condition  and  abnormal 
fermentation  secondary  or  inversely,  whether  fermentation  be  primary 
and  atony  secondary,  is  not  of  importance ;  for  either  view  may  be 
adopted  without  altering  the  results,  and  without  the  theory  being 
invalidated  by  the  objection  that  other  animals  subjected  to  similar 
influences  had  not  contracted  the  condition 

We  have  already  drawn  attention  to  the  importance  of  the  condition 
of  the  animal's  health  for  the  time  being.  Digestive  peristalsis  being 
diminished,  eructation,  admixture  of  food  in  the  rumen,  and  its  onward 
movement  being  impeded,  fermentation  proceeds  rapidly.  As  a  conse- 
quence the  rumen  becomes  distended,  and,  cause  and  effect  changing 
places,  the  distension  in  its  turn  arrests  peristalsis,  which  had  previously 
only  been  checked. 

Local  chills,  produced  by  ingestion  of  food  covered  with  rime,  hoar- 
frost, or  simply  with  dew,  may  favour  gaseous  indigestion ;  such  condi- 
tions retard  or  suspend  the  peristaltic  movements  by  direct  local  action, 
and  probably  by  producing  vaso-motor  disturbance  of  the  mucous  mem- 
brane. In  very  rare  cases  chill  has  an  undeniable  influence,  either  by 
provoking  general  vaso-motor  disturbance,  which  reacts  on  the  secretions, 
or  neuro-motor  trouble.  Gaseous  indigestion  is  not  uncommon  in  animals 
living  on  dry  winter  food,  which  have  been  moved  from  their  ordinary 
quarters  and  sent  on  railway  journeys  or  to  fairs,  etc.  As  a  general 
rule  this  form  of  indigestion  is  commonest  in  spring,  when  the  transi- 
tion from  dry  winter  food  to  grass,  etc.,  has  not  been  carefully 
effected.  It  is  also  frequent  during  stormy  weather  in  full  summer. 
Marked  barometric  changes  seem  to  have  an  influence  on  the  general 


172  INDIGESTION. 

health,  and  particularly  on  the  nervous  system,  thus  favouring  organic 
fermentations. 

Symptoms.  The  earlier  symptoms  of  indigestion  escape  observation, 
but  they  soon  begin  to  develop  rapidly,  and  are  then  very  easy  to  follow. 
They  always  exhibit  the  same  characters,  developing,  however,  with 
more  or  less  rapidity  in  diftei-ent  cases.  Soon  after  they  commence 
feeding  animals  appear  to  experience  special  discomfort,  which  causes 
those  at  grass  to  stop  grazing ;  even  when  stabled  they  stop  feeding. 
From  this  time  they  show  eructation,  repeated  yawning,  restlessness, 
and  some  anxiety. 

In  a  quarter  of  an  hour,  or  less,  the  left  liank  begins  to  project,  both 
laterally  and  vertically,  so  that  eventually  the  walls  of  that  part  of  the 
abdomen  may  project  above  the  transverse  processes  of  the  lumbar 
vertebrae.  The  right  flank  also  becomes  swollen,  as  a  consequence  of 
the  intestine  being  thrust  out  of  position.  The  animal  very  rapidly 
shows  general  disturbance ;  the  nostrils  are  dilated,  the  mucous  mem- 
branes congested,  respiration  becomes  rapid,  and  asphyxia  threatens. 
The  respiration  soon  becomes  panting,  for  the  distended  rumen  para- 
lyses the  diaphragm  and  compresses  the  lungs.  To  ease  respiration 
the  animals  open  the  mouth,  extend  the  neck,  and  stand  with  the 
front  limbs  spread  apart;  but  this  fails  to  prevent  dyspncea  l)ecoming 
more  intense  and  asphyxia  imminent. 

The  heart  beats  more  rapidly,  the  superficial  veins  appear  swollen, 
and  the  mucous  membranes  cyanotic.  The  rhythmic  contractions  of  the 
rumen  can  no  longer  be  detected  by  manual  examination  of  the  left 
flank ;  and  on  auscultation  one  neither  hears  the  liquid  nor  the  rolling 
sound,  but  only  exaggerated  crepitation.  Finally,  there  is  marked 
tympanitic  resonance  on  percussion. 

In  cases  of  very  grave  tympanites  the  gaseous  pressure  in  the 
interior  of  the  rumen  appears  to  stop  the  crepitation  sound.  The 
animals  soon  become  unable  to  walk  or  even  to  move,  suddenly  fall 
to  the  ground,  and  die  rapidly  from  asphyxia. 

The  rapidity  with  which  gaseous  indigestion  develops  varies  greatly. 
Sheep  and  oxen  may  die  from  tympanites,  within  an  hour  or  even  half 
an  hour  of  their  arrival  in  the  field ;  but  more  frequently  the  symptoms 
develop  slowly,  only  becoming  alarming  after  some  hours  and  continuing 
for  twelve  or  even  twenty-four  hours  without  causing  death. 

As  a  rule,  the  gas  is  voided  by  a  series  of  eructations  which  empty  the 
rumen,  and  recovery  follows  ;  but  when  distension  is  extreme  eructation 
cannot  occur,  and  gaseous  indigestion  then  ends  in  asphyxia  and  death. 

Lesions.  It  might  be  imagined  that  this  form  of  indigestion  would 
only  appear  when  the  rumen  contains  a  large  quantity  of  food ;  but, 
in  point  of  fact,  the  rumen  often  contains  very  little. 


GASEOUS   INDIGESTION.  173 

On  post-mortem  examination  the  rumen  is  fomid  to  contain  an 
enormous  quantity  of  gas,  which,  when  collected  and  submitted  to 
analysis,  reveals  approximately  the  following  composition : — Carbonic 
acid,  74  per  cent. ;  carburetted  hydrogen,  24  per  cent. ;  sulphuretted 
hydrogen,  2  per  cent. ;  nitrogen,  traces.  The  composition  of  this 
mixture  varies  within  certain  limits,  according  to  its  origin ;  but 
carbonic  acid  always  predominates. 

Lungwitz,  after  elaborate  experiments  with  different  foods  kept  in 
closed  vessels  at  the  body  temperature  and  with  similar  agents  fed  for 
days  as  an  exclusive  aliment  to  oxen  provided  with  a  fistula  of  the  rumen 
for  purposes  of  collection,  found  carbonic  dioxide  the  predominating  gas 
in  all  cases,  though  the  proportion  varied  with  the  nature  of  the  food. 

Marsh  gas  varied  from  16  to  39  per  cent.,  being  especially  abundant 
in  cases  of  abstinence.  Hydrogen  sulphide  was  found  only  in  traces. 
Oxygen  and  nitrogen  were  present  in  small  amount,  and  were  attributed 
to  air  swallowed  with  the  food.  In  fermentation  the  oxygen  may  be 
completely  consumed. 

The  abdominal  organs,  particularly  the  intestine,  are  congested,  as  a 
result  of  impediment  to  the  venous  circulation.  The  thoracic  organs 
exhibit  the  lesions  of  asphj^xia. 

Pathogeny.  Death  is  due  to  carbonic  acid  poisoning,  brought  about 
in  two  different  ways — viz.,  progressive  asphyxia,  caused  by  inability  to 
inflate  the  lungs,  and  absorption  of  carbonic  acid  gas  from  the  rumen  ; 
by  virtue  of  the  laws  of  diffusion,  part  of  the  gas  contained  in  the  rumen 
passes  into  the  blood. 

The  diagnosis  is  always  very  easy,  and  even  farm  servants  may 
recognise  the  condition. 

The  prognosis  varies,  according  to  the  rapidity  with  which  the 
disease  develops.  In  rapid  cases,  where  the  condition  is  fully  estab- 
lished in  thirty  minutes  to  one  hour,  asphyxia  may  be  threatened 
from  the  beginning ;  but  in  others,  ('jj.,  when  the  attack  follows  con- 
sumption of  dry  food,  tympanites  may  develop  slowly,  only  attaining 
its  maximum  intensity  after  a  considerable  lapse  of  time.  In  general 
one  may  say  that  tympanites  is  grave  in  proportion  to  the  rapidity 
with  which  the  gas  is  generated. 

Treatment.  From  the  prophylactic  point  of  view,  it  is  necessary  to 
avoid  suddenly  changing  animals  from  dry  to  green  food ;  the  transition 
should  be  effected  by  giving  mixtures  of  dry  and  green  food. 
Curative  treatment  comprises  a  large  number  of  methods. 
The  latest,  and  one  of  the  most  practical,  consists  in  massage  of 
the  left  flank.  The  open  hand  is  applied  to  the  left  flank  and  sharply 
pressed  directly  downwards,  care  being  taken  not  to  injure  the  parts. 
This  manipulation  excites  reflex  action,  awakens  the  dormant  contractility 


174  IXDIGESTIOX, 

of  the  rumen,  and  leads  to  restoration  of  peristaltic  movement.  The 
gases  pass  into  the  omasum  and  abomasum,  or  in  many  cases  make  their 
way  into  the  cesophagus.  The  sudden  impulses  somethnes  cause  food  to 
he  returned  into  the  mouth,  eructation  recommences,  and  the  gas  accu- 
mulated in  the  rumen  is  partially  and  progressively  evacuated.  This 
manipulation  is  often  practised  in  breeding  districts,  particularly  in  the 
case  of  sheep,  in  which  the  disease  occurs  with  the  same  characters. 
The  shepherd  fixes  the  animal  between  his  legs,  and,  thrusting  the 
extended  fingers  of  either  hand  into  the  flanks,  makes  sudden,  sharp 
movements,  which  again  set  up  eructation  and  get  rid  of  the  excess  of  gas. 

In  Germany  cold  douches  are  often  applied  to  the  flanks.  These 
excite  vaso-motor  action  and  reflex  peristaltic  movements,  which  result 
in  eructations  and  in  the  evacuation  of  the  rumen.  But  this  is  not  a 
very  practical  method,  and  necessitates  arrangements  which  seldom 
exist  on  sheep  farms. 

The  action  of  massage  may  be  completed  by  administering  stimulants 
like  wine,  alcohol,  or  infusions  of  such  aromatic  plants  as  cummin,  fennel, 
peppermint,  camomile,  etc.  These  act  first  of  all  mechanically,  by  clear- 
ing the  terminal  portion  of  the  oesophagus.  Furthermore,  they  stimulate 
the  mucous  membrane  of  the  rumen,  causing  reflex  peristaltic  contrac- 
tions, and,  as  a  consequence,  circulation  of  the  partly  digested  food ; 
finally,  the  majority  of  them  arrest  fermentation. 

With  the  latter  object,  ether  and  assafoetida  are  also  given.  The  use 
of  these  drugs,  however,  entails  disadvantages,  and  if  the  animal  has 
finally  to  be  slaughtered  renders  the  flesh  unfit  for  consumption. 

The  giving  of  absorbents  is  probably  most  widely  practised.  The 
ammonia  which  many  of  them  contain  absorbs  carbonic  acid,  thereby 
diminishing  the  pressure  of  gas  contained  in  the  rumen,  and  therefore 
the  distension  of  the  first  gastric  reservoirs.  Unfortunately  this  action  is 
only  temporary,  and  if  the  drug  is  given  in  too  concentrated  a  form,  the 
mucous  membrane  of  the  mouth,  of  the  oesophagus,  and  sometimes  even 
of  the  rumen  and  reticulum,  may  be  irritated  and  inflamed,  producing 
lesions  of  stomatitis,  pharjaigitis,  oesophagitis,  contraction  of  the  ceso- 
phagus, etc.,  which  after  recovery  from  the  acute  condition  may  gravely 
aftect  the  animal's  general  health.  A  further  drawback  is  that  the  flesh 
rapidly  acquires  an  ammoniacal  odour. 

Perhaps  the  best  internal  treatment  consists  in  administering  purga- 
tives such  as  hyposulphite  or  sulphate  of  soda  or  sulphate  of  magnesia, 
in  doses  of  10  to  20  ounces,  according  to  the  animal's  size,  or,  in  the 
case  of  pregnant  animals,  in  small  frequently  repeated  doses.  These 
check  fermentation,  and  so  arrest  the  evolution  of  gas,  whilst  by  their 
purgative  properties  they  excite  contraction  of  the  gastric  reservoirs  and 
cause  eructation. 


IMPACTION    OF  THE   RUMEN.  175 

None  of  these  methods  of  treatment,  therefore,  should  be  used 
exclusively,  but  all  may  be  utilised  as  auxiliaries  to  mechanical  or 
surgical  measures,  and  all  should  be  preceded  by  the  use  of  the  pro- 
bang  and  puncture  of  the  rumen. 

The  first  of  these  operations,  the  technique  of  which  scarcely  requires 
description,  is  often  of  little  value  ;  for  the  solids  and  liquid  contents  of 
the  rumen  being  permeated  with  gases,  rise  as  a  fermenting  mass  into 
the  upper  portions  of  the  rumen,  and  continually  obstruct  the  open  end 
of  the  catheter,  so  that  very  little  gas  escapes. 

Puncture  of  the  rumen  is  much  more  effective  and  easier  to  perform. 
The  owner  himself  often  operates  with  an  ordinary  pocket  knife,  some- 
times introducing  a  couple  of  fingers  or  a  short  length  of  elder-wood 
tube  into  the  wound  thus  produced. 

The  incision  should  be  made  at  one  stroke,  for  any  hesitation  may 
cause  the  wall  of  the  abdomen  to  recede  from  the  rumen,  which  lies 
immediately  below.  Should  gas  escape  under  the  skin,  emphysema, 
which  often  extends  to  the  loins  and  along  the  quarters,  may  be  pro- 
duced, and  may  be  followed  by  diffuse  subcutaneous  suppuration,  re- 
sulting from  pyogenic  germs  entering  the  subcutaneous  tissue. 

Large  quantities  of  gas  escape  from  the  puncture,  sometimes  with 
such  force  as  to  drive  out  the  canula.  The  flow  of  gas  then  ceases.  In 
other  cases  the  tube  becomes  blocked ;  because,  as  the  pressure  within 
the  rumen  diminishes,  the  gases  dissolved  or  mixed  with  the  partially 
digested  food  are  freed,  and  the  whole  contents  of  the  rumen  become 
converted  into  an  aerated,  bubbling  mass.  Liquid  or  semi-liquid  materials 
may  be  ejected  to  some  distance,  or  may  pass  between  the  skin  and  the 
muscles,  or  between  the  walls  of  the  rumen  and  the  abdomen,  producing 
various  complications,  like  necrosis,  abscess  formation,  etc.  Such  acci- 
dents can  be  avoided  by  exercising  firm  pressure  with  the  fingers  on  the 
tissues  surrounding  the  canula. 

Even  when  the  rumen  has  resumed  its  normal  size  recovery  is  not 
certain,  and  may  not  occur  for  several  hours,  or  even  several  days,  after- 
wards. The  patients  should  therefore  be  kept  under  observation  for 
some  time,  and  it  is  usually  best  to  leave  the  canula  in  place  for  one  or 
two  days,  and  to  put  the  animal  on  low  diet. 

Necrosis  of  aponeurotic  tissues,  fistula  formation,  and  local  peri- 
tonitis only  occur  if  the  instrument  is  dirty  or  is  introduced  in  a 
wrong   direction. 

IMPACTION    OF    THE    RUMEN.       INDIGESTION    AS    A    RESULT    OF    OVER-EATING. 

In  this  condition  the  rumen  is  over-distended  with  food.  The 
symptoms  are  principally  due  to  abnormal  fermentation,  the  peristaltic 


176  INDIGESTION. 

action  of  the  rumen  being  in  abeyance,  and  the  food  faihng  to  pass  to- 
wards the  omasum  and  abomasum.     Eumination  is  generally'  suppressed. 

The  disease  usually  follows  change  of  diet.  When  the  diet  has  long 
been  restricted,  as  occurs  during  years  of  bad  harvests,  and  animals  are 
afterwards  set  at  liberty  in  rich  pastures,  they  eat  greedily,  distend 
the  rumen  with  large  quantities  of  green  fodder,  and  set  up  all  the 
necessary  conditions  for  this  form  of  indigestion.  Similar  results  follow 
when  gluttonous  animals  are  freely  supplied  with  rich  food.  Working 
oxen  also  suffer  if  withdrawn  from  work  and  fed  with  roots,  beetroot 
refuse,  brewers'  grains,  or  other  manufacturing  residue  for  the  purpose 
of  fattening.  These  materials  can  only  be  absorbed  in  moderate 
quantity,  and  the  large  amount  of  water,  etc.,  they  contain  is  apt  to 
disturb  the  animal's  digestive  powers,  while  owing  to  its  fine  state  of 
division  such  food  cannot  be  returned  to  the  mouth  for  secondary  masti- 
cation, and  rumination  therefore  remains  incomplete:  the  food  accumu- 
lates in  the  rumen,  distending  and  eventually  paralysing  it.  This  is  a 
common  result  of  feeding  on  semi-liquid  pulp,  which  in  order  to  be 
ruminated  should  be  mixed  with  rough  forage. 

Insufficiency  of  drinking  water  is  another  and  more  frequent  cause, 
especially  during  the  winter,  because  the  ox-herd  or  cowman  is  often  too 
lazy  to  give  a  regular  and  sufficient  supply  unless  water  is  laid  on  in  the 
stable  itself.  The  dry  food  l)ecomes  compacted  into  a  mass,  which  cannot 
be  returned  to  the  mouth  for  rumination.  Moreover,  less  saliva  is  then 
secreted,  and  Colin  has  shown  that  rumination  is  impossible  when  the 
parotid  ducts  are  ligatured. 

Symptoms.  As  may  readily  be  imagined,  the  symptoms  vary, 
according  to  the  quantity  and  digestibility  of  the  food  swallowed.  In 
the  first  place  the  appetite  falls  off:  animals  suffering  from  commencing 
indigestion  only  take  part  of  their  food ;  later  on  appetite  ceases,  and 
with  it  rumination.  Trifling  colic  sets  in,  resembling  that  due  to  con- 
gestion, and  is  indicated  by  unrest,  switching  of  the  tail,  lifting  of  the 
hind  legs,  slight  groaning,  moving  from  side  to  side,  and  lying  down 
and  rising  at  short  intervals.  The  animals  seem  oblivious  of  their  sur- 
roundings, anxious,  and  at  times  semi-comatose. 

When  the  case  has  been  neglected  for  several  days  the  animal  may 
masticate  without  having  any  food  in  the  mouth,  and  may  attempt  to 
eructate  and  to  regurgitate  food  ;  but  such  attempts  always  fail.  It  then 
absolutely  refuses  food,  and  animals  which  have  eaten  large  quantities  of 
green  forage  may  show  tympanites.  If  called  in  at  this  period  of  the 
disease  the  veterinary  surgeon  finds  nothing  positive  except  signs  refer- 
able to  the  digestive  apparatus.  By  methodically  examining  the  digestive 
tract,  and  in  particular  the  stomachs,  one  discovers  during  palpation  of 
the  left  Hank  that  the  rumen  is  distended.     This  is  characteristic.     By 


IMPACTION    OF   THE    RUMEN.  177 

palpation  it  is  even  possible  to  detect  marked  resistance  and  a 
certain  characteristic  tirmness  resulting  from  accumulation  of  food.  The 
percussion  sounds  over  this  region  are  dull,  and  pressure  causes  pain,  as 
though  the  rumen  and  peritoneum  were  inflamed.  When  the  open  hand 
is  laid  flat  on  the  rumen  and  thrust  downwards,  no  peristaltic  move- 
ment can  be  discovered.  Finally,  on  auscultation  the  normal  sounds, 
including  crepitation,  fermentation,  and  rolling  sounds  are  all  absent. 

There  are  no  well-marked  general  symptoms.  Kespiration  and 
circulation  are  hardly  accelerated,  nor  is  the  artery  particularly  tense- 
Course  and  Termination.  The  course  of  the  disease  varies,  and  the 
condition  may  be  divided  into  two  forms,  acute  and  chronic.  The  first 
develops  in  a  single  day,  and  may  cause  death  by  the  same  mechanism 
as  acute  tympanites — i.e.,  asphyxia  or  carbonic  acid  poisoning ;  the 
other  continues  for  five,  ten,  or  even  twenty  or  thirty  days,  according  to 
the  promptitude  with  which  treatment  is  undertaken. 

In  protracted  cases,  however,  the  indigestion  itself  ceases  to  be  as  im- 
portant  as  the  complications.  Sometimes  spontaneous  recovery  occurs, 
the  food  passing  away  towards  the  intestine,  or  even  being  vomited, 
though  the  latter  conclusion  is  rare.  Eecovery  may  also  follow  from 
treatment.  If  the  disease  is  neglected  it  may  become  complicated  with 
gastro-enteritis. 

The  diagnosis  is  not  very  difficult.  Indigestion  resulting  from  im- 
paction is  distinguished  from  acute  tympanites  by  its  less  rapid  course 
and  by  the  less  marked  distension  of  the  rumen  (in  this  case  due  to  solid 
food),  and  from  acute  gastro-enteritis  by  the  varying  degree  of  fever 
which  accompanies  the  latter  condition. 

Prognosis.  The  prognosis  is  always  grave,  even  in  cases  of  acute 
indigestion  resulting  from  eating  green  food. 

In  this  case  gaseous  indigestion  occurs  as  a  complication,  and  neces- 
sitates immediate  intervention.  The  other  forms  may  rapidly  yield  to 
proper  treatment,  or,  in  spite  of  every  care,  may  give  rise  to  prolonged 
complications. 

Lesions.  On  post-mortem  examination  of  animals  which  have  died 
of  complicated  forms  of  the  disease,  we  find  certain  lesions  peculiar  to 
gaseous  indigestion  associated  with  impaction  of  the  rumen. 

If  death  has  followed  the  consumption  of  root  pulps,  we  see  signs  of 
poisoning.  As  a  consequence  of  prolonged  stagnation  of  food  in  the 
rumen,  there  follows  an  exaggerated  organic  fermentation,  whose  pro- 
ducts are  absorbed  through  the  stomach  or  intestine  and  pass  into  the 
circulation. 

These  various  fermentations,  which  may  be  of  the  lactic,  butyric, 
and  even  putrid  order,  produce  changes  in  the  mucous  membrane  of  the 
rumen  ;  wide  tracts  of  the  epithelium  may  be  shed,  exposing  the  corium, 
u.c.  N 


178  INDIGESTION. 

and  producing  enormous  ulcerations,  which  in  certain  cases  implicate  the 
entire  inner  surface  of  the  rumen. 

The  treatment  must  be  varied,  according  to  the  cause,  symptoms, 
and  immediate  complications.  When  the  disease  is  of  an  acute  type, 
such  as  that  produced  by  over-gorging  with  lucern  and  green  food,  it  is 
best  to  proceed  as  in  gaseous  indigestion,  i.e.,  to  puncture  the  rumen  and 
give  frequent  large  doses  of  purgatives  until  the  stomach  and  bowels  have 
been  freely  unloaded.  The  animals  should  then  be  kept  for  some  days 
on  small  quantities  of  easily  digested  food,  and  should  be  allowed  luke- 
warm, mucilaginous  drinks. 

When  tympanites  and  impaction  occur  simultaneously,  immediate 
surgical  intervention  becomes  necessary,  and  gastrotomy  may  then  he 
performed  by  a  very  simple  method. 

Two  loops  of  cord  are  passed  around  the  abdomen,  one  behind  the 
hypochondriac  circle,  the  other  in  front  of  the  angle  of  the  haunch. 
Assistants  placed  on  the  right  side  draw  these  loops  tight,  so  as  to  im- 
mobilise the  left  flank.  A  bistoury  is  then  thrust  directly  through  the 
walls  of  the  abdomen  and  rumen.  As  a  consequence  of  the  pressure 
exercised  by  the  ropes,  if  not  of  the  pressure  of  gas  itself,  the  food  material 
contained  in  the  rumen  is  often  expelled  in  a  powerful  stream.  As  the 
superposed  tissues  cannot  very  readily  change  their  mutual  relations,  the 
author  of  this  suggestion  claims  that  there  is  little  danger  either  of  in- 
fectious materials  passing  into  the  subcutaneous  connective  tissue,  or  of 
peritonitis ;  but  this  rude  treatment  can  only  be  resorted  to  in  cases  of 
extreme  urgency,  and  it  appears  by  no  means  without  danger. 

Injections  of  10  to  15  centigrammes  of  pilocarpine  and  5  to  10  centi- 
grammes of  eserine  are  also  useful. 

When  impaction  of  the  rumen  assumes  a  less  acute  form,  moderate 
doses  of  purgatives  may  be  given  and  repeated  daily,  or  twice  a  day,  until 
the  peristaltic  action  of  the  rumen  is  restored  and  resumes  its  normal 
rhythm.  In  certain  cases,  however,  recovery  is  only  apparent.  The 
food  in  contact  with  the  walls  of  the  rumen  breaks  down,  and  passes 
away  into  the  abomasum  and  intestine,  while  appetite  returns.  The 
animals  then  resume  feeding,  and  some  days  afterwards  show  all  their 
former  symptoms.  Low  diet  should  therefore  always  be  continued  for 
some  time. 

In  spite  of  treatment,  or  in  consequence  of  treatment  being  too  long 
delayed,  no  improvement  may  follow.  The  ingested  food  is  not  expelled. 
Putrid  fermentation  results,  auto-intoxication  sets  in,  and  the  tempera- 
ture rises  to  40°  or  41"  C.  Unless  gastrotomy  is  performed  death  is  then 
certain. 

This  operation  should  be  undertaken  whenever  the  fever  rises  to  40°  C, 
and  two-thirds  of  the  contents  of  the  rumen  removed.     The  rumen  should 


IMPACTION   OF   THE   OMASUM    (THIRD    STOMACH).  179 

not  be  completely  emptied,  as  there  is  danger  of  collapse  of  its  walls. 
Complications  in  the  region  of  the  wound  can  be  avoided  by  drainage. 

If  the  operation  succeeds,  the  patients  must  be  placed  on  very  low 
diet  or  on  milk  for  some  days,  and  should  be  given  lukewarm  farinaceous 
drinks,  and  a  little  hay  of  good  quality  to  excite  rumination.  In  old 
milch  cows  this  operation  is  seldom  followed  by  a  satisfactory  recovery. 
Apart  from  the  loss  of  milk,  the  animal  loses  condition,  refuses  to  feed, 
and  gradually  succumbs  to  exhaustion. 

IMPACTION    OF    THE    OMASUM    (xHIRD    STOMACH), 

Definition.  "A  form  of  indigestion,  of  which  the  prominent  feature 
is  the  drying  and  impaction  of  the  ingesta  between  the  folds  of  the  third 
stomach.  It  may  seem  to  be  a  primary  disease,  but  in  very  many  cases 
it  occurs  as  a  result  of  some  acute  febrile  or  inflammatory  affection." 
(Law's  "  Veterinary  Medicine,"  Vol.  II.  p.  123.) 

Synonyms.  Dry  murrain,  clew-bound,  fardel-bound,  stomach  stag- 
gers, grass  staggers,  vertigo,  chronic  dyspepsia,  chronic  indigestion. 

Causes.  Torpidity  of  the  omasum,  suppression  of  salivary  secretion, 
with  absence  of  "  waves  of  liquid  floating  the  flnely  divided  food  from  the 
mouth  or  rumen  to  third  stomach,  are  prime  conditions  of  desiccation  of 
the  contents."  The  third  stomach,  like  the  first  and  second,  has  no  pro- 
vision for  liquid  secretion,  and  depends  for  its  supply  on  constant  flush-*^ 
ing  by  swallowed  fluids.  Therefore,  if  feeding  and  rumination  are 
arrested  and  salivary  secretion  is  suppressed,  and  if  movements  of  the 
rumen  and  resulting  overflow  into  the  third  stomach  are  checked,  the 
ingesta  of  the  third  stomach,  compressed  between  its  folds,  becomes 
drained  of  liquid  and  converted  into  a  powder  or  dry  mass.  All  febrile 
and  inflammatory  affections  tend  to  this  end,  and  more  or  less  dryino- 
with  impaction  of  the  contents  of  the  omasum,  is  a  constant  feature  in 
such  cases.  But  in  the  majority  of  cases  this  condition  is  to  be  looked 
on  as  a  secondary  or  subsidiary  aft'ection,  and  the  real  disease  must  be 
sought  elsewhere. 

The  explanation  of  the  susceptibility  of  the  third  stomach  in  consti- 
tutional troubles  has  been  sought  in  the  source  of  its  innervation.  Electric 
stimulation  of  the  vagus  rouses  the  movements  of  the  first  and  second 
stomachs,  but  not  those  of  the  third.  Action  of  the  third  stomach  is 
excited  by  stimulation  of  the  spinal  cord,  and  of  the  sympathetic  nervous 
branches  going  to  the  ganglionic  cells  in  the  \Yalls  of  the  omasum  (Colin 
and  Ellenberger).  Its  nerve  supply _coming  from  a  difierent  source,  de- 
rangement of  its  function  may  occur  independently  of  antecedent  disorder 
of  the  first  or  second,  and  its  motor  supply  coming  from  a  source  so  closely 
related  to  the  vaso-motor  centres,  perhaps  aftbrds  some  explanation  of  the 

N  2 


180  INDIGESTION. 

connection  of  disorders  of  the  omasum  ^Yitll  febrile  and  inflammatory 
diseases. 

Food  is  an  important  cause.  Impaction  of  the  omasum  is  a  winter 
disease — the  time  of  dry  feeding.  Dry,  fibrous,  innutritions  fodder,  and 
scarcity  of  water  contribute  to  its  production.  It  attacks  cattle  in  spring 
or  autumn  on  pastures  in  which  fresh  grass  grows  among  the  dead, 
dried,  or  withered  stems  of  a  previous  growth.  It  occurs  when  stock 
are  fed  on  corn  or  corn  stalks  (maize  stalks)  affected  with  smut  or  ergot, 
or  on  cereals  or  grasses  similarly  damaged,  and  in  both  cases  especially 
when  the  water  supply  is  deficient  or  restricted. 

Sheep  and  goats,  which  habitually  drink  little,  suffer  less  than  do 
cattle,  which  drink  freely. 

Other  causes.  Fermented  foods,  microbian  ferments  and  their  pro- 
ducts, which  tend  to  induce  torpidity  of  the  omasum,  fever,  and  lessened 
secretion  of  saliva,  with  diminished  supply  of  liquid  from  mouth  or  rumen. 

Pericarditis,  by  causing  vascular  stasis  m  the  omasum,  may  induce 
torpor  and  imj^action. 

Lead  poisoning  paralyses  action  and  favours  impaction.  Finely 
divided  food  stuffs — meal  and  bran — eaten  greedily,  may  pass  in  quantity 
directly  into  the  omasum  and  induce  impaction.  "  The  most  acute  and 
fatal  forms  occur  in  connection  with  a  sudden  change  from  dry  to  rich, 
luscious,  green  food  in  spring,  the  unwonted  stimulus  giving  rise  to 
■  general  irritation  of  the  whole  gastric  mucosa,  with  disordered  and  im- 
paired function  of  all  four  stomachs,  but  especially  of  the  third.  Such 
cases  are  usually  congestive  and  inflammatory,  and  the  suspension  of  the 
gastric  movements  is  a  grand  cause  of  impaction.  In  such  cases,  too, 
the  brain  or  spinal  cord,  or  both,  are  seriously  involved,  and  the  early 
death  is  preceded  by  torpor,  paralysis,  violent  delirium  or  convulsions, 
following  largely  the  type  of  acute  lead  poisoning."     (Law,  loc.  cit.) 

The  symptoms  depend  on  the  degree  of  impaction,  and  vary  from 
simple,  irregular,  or  suspended  rumination  to  severe  gastric  and  nervous 
disorder.  The  less  acute  cases  are  marked  by  failure  to  re-establish 
regular  rumination  or  partial  convalescence  from  fever  or  inflammation. 
The  fever  subsides,  but  the  appetite  remains  capricious,  the  muzzle  dry, 
eyes  dull,  spirits  low,  and  breathing  accelerated ;  the  condition  is  some- 
times accompanied  by  moaning.  Slight  tympanites  may  appear,  and 
the  contents  of  the  rumen  may  feel  solid,  the  mouth  hot,  clammy,  and 
foetid.  The  bowels  are  constipated,  the  fftces  small  in  quantity,  hard, 
covered  with  mucus  or  blood- streaked,  and  containing  particles  of  undi- 
gested food ;  in  other  cases  diarrhoea  may  set  in,  to  be  followed  later  by 
constipation.  Alternations  of  constipation  and  diarrhoea  may  be  repeated 
again  and  again.  Exploration  by  pressure  of  the  closed  hand  over  the 
omasum  will  give  an  impression  of  solid  resistance.     There  may  be  slight 


IMPACTION   OF   THE   OMASUM    (THIRD    STOMACH).  181 

shivering,  the  ears  and  limbs  are  cold,  the  hair  is  erect  in  patches,  dry 
and  lustreless. 

In  cases  occurring  independently  of  previous  disease,  diarrhoea  may 
be  the  first  symptom  observed,  the  malady  being  preceded  by  local  irrita- 
tion and  congestion  ;  but  this  soon  gives  place  to  constipation  or  diarrhcea 
and  the  symptoms  above  mentioned.  The  animal  is  found  lying  apart 
on  its  left  side,  with  its  nose  in  its  right  flank,  the  pulse  and  breathing 
quickened,  the  eyes  congested ;  expiration  is  accompanied  by  a  grunt. 
The  patient  walks  with  its  back  arched  and  dragging  its  limbs.  The 
appetite  may  continue,  but  only  in  an  impaired  and  irregular  form,  and 
as  rumination  ceases  grinding  of  the  teeth  becomes  common.  The 
secretion  of  milk  is  diminished  or  arrested,  emaciation  advances  day  by 
day.  Fcetid  eructation  may  be  a  marked  symptom.  This  form  may 
last  from  ten  to  fourteen  days,  and  merge  finally  into  paralysis  of  the 
hind  limbs,  drowsiness  and  stupor,  or  delirium  and  convulsions. 

"In  more  acute  cases  (from  sudden  access  of  green  food,  change  of 
water,  or  ingestion  of  irritant  plants),  the  affection  partakes  more  or 
less  of  the  nature  of  congestion  or  inflammation  of  the  viscus  (omasitis), 
and  may  run  a  rapidly  fatal  course"  (Law,  loc.  cit.).  The  animal  is  seen 
apart  from  the  herd  in  a  characteristic  recumbent  position,  the  eyes  are 
red  and  glassy,  the  eyelids  semi-closed,  the  patient  shows  much  drowsi- 
ness and  stupor,  but  when  raised  may  still  feed  in  a  sleepy,  listless 
manner.  The  bowels  are  loose  or  confined,  the  pulse  and  breathing 
accelerated,  the  right  hypo-chondrium  is  firm  and  tender,  and  the  sound 
of  fermentation  absent  or  subdued  over  the  omasum.  Soon  nervous  dis- 
order appears,  the  eyes  glare  wildly,  the  animal  seeks  relief  in  motion — ■ 
sometimes  in  a  straight  line,  sometimes  to  one  side — and  being  blind  and 
unconscious  of  obstacles,  may  fall  into  pits  or  ditches,  knock  against 
trees,  fences,  gates,  or  buildings,  and  continue  pushing  against  resisting 
objects,  breaking  its  horns  or  teeth;  and  otherwise  sustaining  injury 
through  violent  muscular  contractions. 

Course.  Chronic  cases  may  continue  indefinitely,  with  symptoms  of 
poor  health,  impaired  digestion,  and  gradual  loss  of  condition.  After 
death  the  omasum  may  contain  dried  food  which  the  animal  consumed 
several  months  before  the  attack. 

In  cases  ending  in  early  recovery  there  occurs  abundant  diarrhcea, 
"the  ffeces  are  mixed  with  flattened,  dark,  solid,  and  polished  masses,  the 
impacted  ingesta  from  the  omasum.  Tympany  subsides  ;  movement 
in  rumen  and  omasum  and  rumbling  in  bowels  can  be  heard.  Appetite 
returns."     (Law.) 

Diagnosis.  The  condition  of  the  pulse  and  respiration,  and  the 
grunting  with  expiration  may  lead  to  confusion  with  pneumonia. 

At  first  there  is  no  fever,  tenderness  is  confined  to  the  right  flaxrk ; 


182  INDIGESTION. 

there  is  an  absence  of  pulmonary  crepitation,  of  pleural  effusion, 
and  of  movement  in  the  rumen  and  omasum.  Signs  of  gastric  and 
intestinal  disorder  can  be  detected. 

Lesions.  The  omasum  is  gorged — it  may  be  twice  its  normal  size — 
solid,  resistant,  almost  stony.  The  spaces  between  the  leaves  are 
packed  with  dried  food,  which,  when  removed,  carries  a  layer  of  epi- 
thelium from  the  mucous  meml)rane.  (This  (layer  on  contents)  is  not 
inconsistent  with  health.) 

The  rumen  contains  ingesta  packed  in  masses,  more  or  less  offensive 
from  putrefaction. 

The  abomasum  is  empty  of  food,  but  contains  much  mucus.  Its 
mucous  membrane  is  congested. 

The  small  intestine  is  red  in  places,  empty  and  collapsed. 

The  larger  intestine  contains  a  quantity  of  dry,  glistening  pellets,  and 
much  mucus. 

Treatment  follows  the  lines  of  impaction  of  rumen,  though  the 
response  is  usually  less  certain,  and  always  slower.  Flax-seed  tea, 
several  bucketfuls  per  day,  will  often  succeed. 

Epsom  and  common  salts,  with  sol.  ammoniae,  excite  thirst ;  licpiids 
should  be  supplied  freely. 

In  obstinate  cases,  and  in  absence  of  gastric  or  cerebral  congestion, 
20  croton  beans,  or  20  drops  of  croton  oil,  may  be  added  to  the  purgative. 
Nux  vomica  stimulates  the  nervous  supply.  Enemata  may  be  given 
freely. 

Other  remedies,  stimulating  contractility  and  secretion,  are  :  Eserine, 
1^  grains  ;  veratrine,  1  grain  ;  barium  chloride,  10  to  15  grains ;  or  pilo- 
carpin,  3  grains,  hypodermically. 

The  patient  may  be  days  or  even  a  week  without  alvine  discharge  and 
recover. 

If  fever  and  symptoms  of  gastric  congestion  appear,  a  blister  may  be 
applied  to  the  right  side  over  the  omasum. 

Nervous  symptoms,  such  as  dilated  pupils,  blindness,  congested 
mucous  membrane,  hot  horns  and  ears,  drowsiness  or  excitement,  are 
combated  by  applying  cold  water  or  ice  to  poll,  etc. 

When  free  action  of  the  bowels  is  restored,  laxative  diet,  roots 
(pulped),  green  food,  plenty  of  common  salt,  and  free  access  to  drinking 
water  should  be  prescribed. 

During  convalescence  a  course  of  tonics,  including  nux  vomica,  is 
advisable  to  help  in  restoring  normal  gastric  functions. 

ABOMASAL    INDIGESTION. 

Primary  indigestion  in  the  abomasum  appears  to  be  rare  in  adults, 
for  until  the  present  time  no  one  has  given  a  sufficiently  characteristic 


ABOMASAL  INDIGESTION.  183 

description  of  this  disease  to  enable  it  readily  to  be  recognised.  On  the 
other  hand,  it  is  to  be  presumed,  although  final  proof  has  certainly  not 
been  furnished,  that  in  cases  of  gaseous  indigestion,  or  of  impaction  of 
the  rumen,  the  abomasum,  whose  physiological  action  is  predominant, 
must  simultaneously  suffer. 

Primary  abomasal  indigestion,  on  the  contrary,  is  common  in  young 
animals  before  weaning,  so  that  the  condition  has  been  given  the  name 
of  "milk  indigestion."  It  could  not  very  well  be  otherwise,  for  the 
abomasum  is  the  only  one  of  the  gastric  divisions  which  in  ruminants 
is  active  during  the  first  few  weeks  of  life.  At  this  period  it  is  larger 
than  the  other  gastric  reservoirs ;  and  the  rumen,  the  reticulum,  and  the 
omasum  do  not  undergo  great  development  till  weaning  begins. 

Causation.  Milk  indigestion  attacks  young  animals,  under  varying 
conditions. 

In  animals  suckled  by  the  mother  the  disease  rarely  occurs,  but  yet 
when  the  mothers  are  good  milkers,  like  the  Flemish,  Norman,  Jersey, 
and  Holland  breeds,  and  when  there  is  too  long  an  interval  between  the 
feeds,  calves,  which  are  naturally  greedy,  and  in  addition  are  hungry,  are 
apt  to  take  too  large  a  quantity  of  milk — in  fact,  they  often  gorge  to  the 
fullest  possible  extent.  Owing  to  its  over-distended  state  the  abomasum 
either  fails  to  secrete  sufficient  of  the  rennet  ferment  necessary  for 
coagulating  the  milk  or  secretes  an  insufficiently  active  ferment.  The 
first  stage  of  digestion  remains  incomplete,  giving  rise  to  so-called 
"milk  indigestion." 

When  the  cows  are  employed  in  ploughing,  etc.,  or  in  drawing  carts, 
not  only  are  the  calves  fed  at  long  intervals,  but  the  milk  is  not  always 
of  proper  chemical  composition  even  in  the  udder.  As  a  result  of 
work,  fatigue,  over-exertion  and  irregular  feeding,  the  cow's  yield  of  milk 
for  the  time  is  less  digestible  than  the  normal  supply,  or  may  even  prove 
irritant  to  the  calf's  stomach.     Milk  indigestion  is  thus  set  up. 

When  the  cows  are  fed  on  factory  waste,  like  beetroot-pulp  or  brewers' 
grains,  toxic  or  irritant  products  may  even  find  their  way  into  the  milk, 
which  then  irritates  the  little  creature's  abomasum  and  produces  gastric 
indigestion.  Just  as  in  the  production  of  congenital  alcoholism  in  man, 
the  young  animal  is  then  ingesting,  unknown  to  those  responsible  for 
its  well-being,  chemical  substances  which  produce  various  pathological 
changes. 

But  milk  indigestion  is  commonest  of  all  in  calves  fed  by  hand.  The 
food  usually  given  is  a  mixture  of  milk  from  the  previous  night,  and 
skim  milk  or  even  butter  milk.  It  contains  lactic  ferments  and  various 
microbes,  some  capable  of  producing  toxic  principles. 

When  swallowed  and  brought  directly  in  contact  with  the  mucous 
membrane  these  cause  abomasal  indigestion. 


184  INDIGESTION. 

Symptoms.  Soon  after  feeding,  the  little  animal  appears  dull  and 
somnolent,  and  shows  moderate  abdominal  pain,  suggesting  trifling 
colic. 

This  stage  is  soon  followed  by  nausea ;  the  breathing  and  the  heart's 
action  become  rapid,  vomiting  efforts  are  made,  and  finally  milk,  in 
the  form  of  firm  or  partially  softened  curds,  depending  on  the  time  which 
has  elapsed  since  the  last  feed  was  taken,  are  vomited.  The  quantity 
ejected  varies.  Pressure  over  the  right  side  of  the  abdomen  produces 
pain,  and  tympanites  of  the  abomasum  may  sometimes  be  detected  on 
percussion. 

The  sensitiveness  and  gaseous  inflation  are  confined  to  the  middle 
and  lower  zone  of  the  hypochondrium.  Soon  after  vomiting  the  animal 
begins  to  improve.  The  patient  seems  brighter,  relief  is  very  marked, 
and  in  some  cases  proves  permanent ;  but  more  frequently  a  certain 
degree  of  depression  persists,  the  mouth  emits  a  sourish  odour,  and  for 
a  time  the  appetite  remains  poor.  This  temporary  irritation  of  the 
abomasum  has  a  tendency  to  become  permanent ;  or  even  to  extend  to 
the  intestine,  in  which  the  conditions  appear  more  favourable  to  the 
development  of  micro-organisms  than  do  those  in  the  stomach.  In- 
digestion then  becomes  complicated  with  diarrhceic  enteritis. 

The  diagnosis  presents  no  difficulty. 

The  prognosis  is  not  serious,  provided  that  the  young  animals  are 
carefully  attended  to  ;  but  such  complications  as  diarrhoeic  enteritis  may 
become  very  grave  if  neglected. 

The  treatment.     To  prevent  recurrences  : 

(1)  The  periods  of  feeding  should  be  regulated  ; 

(2)  The  cows  should  not  be  worked,  or  should  be  worked  as  little  as 
possible  ; 

(3)  Mixed  milk,  or  milk  which  has  already  undergone  lactic  or  other 
fermentation,  should  be  avoided. 

If  the  calves  must  be  reared  by  hand,  the  mixed  milk  should  at  least 
be  boiled  or  relatively  pasteurised  by  heating  to  70°  or  80°  C,  and  the 
buckets  used  for  feeding  should  be  kept  scrupulously  clean.  These 
precautions  become  absolutely  necessary  when  diarrhcea  exists  amongst 
the  calves.  Curative  treatment  consists  in  placing  the  animals  on  low 
diet  for  two  or  three  days  after  the  attack  of  indigestion,  or  in  giving 
them  boiled  milk  diluted  with  from  one-half  to  two-thirds  of  boiled 
water. 

The  addition  of  a  mild  saline  purgative  like  sulphate  of  soda,  in  doses 
of  one-half  to  three-quarters  of  an  ounce,  usually  ensures  a  cure. 
Infusions  of  lime-tree  flowers,  peppermint,  camomile,  etc.,  may  ad- 
vantageously be  used  to  replace  boiled  water  in  diluting  the  first 
foods. 


ACUTE   GASTRIC   INDIGESTION    IN    SWINE.  185 

ACUTE    GASTRIC    INDIGESTION    IN    SWINE. 

The  causes  comprise  putrid  food,  swill,  spoilt  turnips,  potatoes, 
apples,  succulent  vegetables,  frozen  food,  and  the  admixture  of  caustic 
alkaline  powders  (used  in  washing  table  dishes)  with  the  swill.  Indi- 
gestible matters — hoof,  horn,  hair,  bristles,  tree  bark,  etc. — when  not  re- 
jected by  vomiting,  cause  gastritis  and  indigestion.  Lastly,  medicinal 
substances  and  poisons,  paint  and  lead,  sometimes  produce  the  disease. 

Among  the  symptoms  may  be  mentioned  dulness,  arching  of  the 
back,  standing  with  the  feet  brought  together,  erection  of  the  bristles, 
hiding  under  the  litter,  grunting,  uneasiness,  shifting  from  place  to 
place,  tenseness  of  the  abdominal  wall,  borborygmus ;  these  may  be 
followed  by  diarrhoea  and  recovery.  Speedier  relief  is  aftbrded  by 
copious  vomiting  of  irritant  matters. 

The  treatment  should  commence  with  the  free  administration  of 
emetics.  To  combat  alkaline  poisoning  vinegar  may  be  given,  followed 
by  a  laxative.     Prophylaxis  calls  for  greater  care  in  feeding. 


CHAPTER    V. 

ACUTE    INFLAMMATION    OF    THE    GASTRIC    COM- 
PARTMENTS. 

RUMENITIS-RETICULITIS    GASTRITIS. 

Causation.  Acute  primary  inflammation  of  the  first  gastric  reser- 
voirs, viz.,  the  rumen  and  reticulum,  is  not  common.  It  sometimes 
accompanies  such  infectious  disorders  as  foot-and-mouth  disease,  gan- 
grenous coryza,  etc.,  hut  then  constitutes  an  added  phenomenon  which 
should  be  studied  along  with  the  original  disease  itself.  Piumenitis  or 
reticulitis  may  however  follow  the  ingestion  of  irritant  foods  or  plants, 
of  very  hot  liquids,  and  more  frequently  still  of  unskilfully  compounded 
medicines.  In  such  cases  the  mucous  membrane  is  directly  attacked, 
and  pathological  congestion,  infiltration,  and  desquamation  may  follow, 
or  even'  vesicles  and  ulcerations  may  rapidly  be  formed. 

Symptoms.  Inflammation  of  the  rumen  or  reticulum  is  announced 
by  loss  of  appetite,  suspension  of  rumination  or  of  regular  peristalsis, 
sUght  tympanites,  and  particularly  by  excessive  sensitiveness  to  palpa- 
tion. This  sensitiveness  is  general,  but  is  more  specially  marked  in 
the  left  lower  third  of  the  abdominal  cavity,  and  in  the  retro-ensiform 
region  which  corresponds  to  the  position  of  the  reticulum.  Moderate 
fever  is  present. 

These  symptoms,  which  indicate  the  gravity  and  intensity  of  the 
inflammation,  may  persist,  become  aggravated,  provoke  vomiting  from 
the  rumen,  and  leave  as  a  legacy  motor  dyspepsia,  or  even  more  serious 
consequences.  On  the  other  hand,  they  may  progressively  diminish 
and  disappear  for  good. 

Lesions.  The  lesions  comprise  hj-pertemia  of  the  walls  of  the  rumen 
and  of  the  mucous  membrane,  extensive  local  exfoliation  of  epithelium, 
and  sometimes  true  ulceration  of  the  mucous  membrane. 

Diagnosis.  The  diagnosis  is  based  on  the  exceptional  sensitiveness  of 
the  gastric  compartments  on  palpation,  and  also  on  the  history,  provided 
relial)le  information  can  be  obtained. 

Prognosis.  The  j)rognosis  should  be  reserved,  because  it  is  never 
possible  to  foretell  whether  acute  lesions  may  not  give  place  to  chronic 


RUMENITIS — RETICULITIS — GASTRITIS.  187 

disease,  which,  though  apparently  luiimportant,  may  terminate  in  grave 
consequences. 

Treatment.  Owing  to  their  local  action  demulcent  drinks  and  teas 
are  indicated.  Cooked  food  is  useful,  hecause  it  makes  little  demand  on 
the  digestive  powers ;  steamed  hay  and  farinaceous  suhstances  are 
given,  hoth  on  account  of  their  nutritious  qualities  and  of  the  slight 
local  irritation  they  cause  when  swallowed. 

Lukewarm  drinks  and  saline  laxatives,  such  as  the  sulphate  of  soda,  and 
carbonate  of  soda  or  Carlsbad  salt  in  small  doses  of  1^  to  2  ounces,  seem 
most  useful  in  combatting  the  reflex  atony  of  the  digestive  compartments. 

Inflammation  of  the  omasum,  like  that  of  the  rumen  and  reticulum, 
occurs  as  a  secondary  phenomenon  in  conditions  like  rinderpest,  Texas 
fever,  foot-and-mouth  disease,  anthrax,  and  gangrenous  coryza  (malig- 
nant catarrh)  ;  but  primary  inflammation  is  much  rarer  even  than  that 
of  the  rumen  and  of  the  reticulum. 

This  is  accounted  for  by  the  deep  position  of  the  omasum,  which  is 
thus  sheltered  from  external  violence,  early  contact  with  irritant  foods  and 
from  the  effect  of  chills,  etc.  It  can  only  become  inflamed  by  the  prolonged 
action  of  irritant  food  and  drink,  which  have  already  produced  lesions  in 
the  rumen  and  reticulum  ;  or  as  a  consequence  of  the  prolonged  stagnation 
of  dry  food  in  cases  where  animals  have  been  deprived  of  water. 

Under  these  conditions  inflammation  of  the  omasum  develops  slowly, 
and  from  the  clinical  point  of  view  is  identical  with  what  was  formerly 
known  as  obstruction  of  the  omasum.  Obstruction  or  impaction  is 
probably  much  rarer  than  has  been  stated,  in  so  far  at  least  as  it  con- 
stitutes a  primary  condition,  for  in  the  great  majority  of  cases  it  is 
consecutive  to  impaction,  inflammation  of  the  rumen,  or  inflammation 
of  the  abomasum.  Obstruction  of  the  omasum,  which  was  formerly 
invoked  in  all  doubtful  and  ill-defined  cases  of  digestive  disturbance, 
seldom  occurs  as  an  isolated  disease. 

It  has  been  suggested  that  the  omasum,  being  supplied  with  nerves 
solely  by  the  sympathetic  system,  and  provided  with  a  relatively  weak 
muscular  coat,  was  more  susceptible  than  the  other  reservoirs  to  the 
reaction  of  abdominal  reflexes,  and  therefore  more  subject  to  inflam- 
mation, indigestion  and  obstruction.  We  do  not  hold  that  view,  because, 
as  a  result  of  its  general  situation  and  the  position  of  its  orifices  of 
communication,  this  compartment  is  easily  able  to  expel  its  contents 
so  long  as  they  are  liquid.  Its  function  appears  chiefly  to  be  to  complete 
the  trituration  of  food  after  rumination. 

We  do  not  consider  that  inflammation  of  the  omasum  never  occurs, 
for  we  are  well  aware  of  the  contrary,  and  that  the  inflammation  assumes 
a  subacute  course  and  is  accompanied  by  stasis  of  the  semi-digested  food 
between  the  mucous  leaves  which  partly  fill  the  cavity.     We  simply  wish 


188  ACUTE    INFLAMMATION   OF   THE   GASTRIC   COMPARTMENTS. 

to  emi^hasise  the  view  that  the  condition  is  not  a  primary  and  isolated 
inliammation. 

Symptoms.  The  symptoms  are  always  vague  and  very  difficult 
clearly  to  define. 

Inflammation  of  the  omasum  is  indicated  hy  relative  loss  of  appetite, 
marked  thirst,  general  atony,  and  diffuse  and  vague  sensitiveness  in  the 
inferior  half  of  the  right  hypochondrium  (zone  of  the  asternal  ril)s). 
There  are  no  pathognomonic  symptoms. 

Obstruction  has  also  been  described  as  accompanied  by  loss  of 
appetite,  constipation,  the  passage  of  black,  coated,  foetid  and  sometimes 
blood-streaked  fteces,  symptoms  of  chronic  tympanites  with  foetid  eructa- 
tions and  sometimes  vomiting.  These  sometimes  accompany  hydrochloric 
acid  dyspepsia,  a  form  of  chronic  gastritis,  and,  from  our  standpoint,  the 
stagnation  of  food  in  the  omasum  is  only  secondary.  We  therefore 
interpret  the  facts  in  quite  a  different  manner,  and  believe  that  only  by 
a  rational  and  physiological  interpretation  of  the  symptoms  ol)served  can 
one  diagnose  the  condition. 

Diagnosis.  The  diagnosis  of  inflammation  of  the  omasum  can  only 
be  made  l\y  a  process  of  exclusion  ;  and  although  we  are  admittedly 
dealing  with  a  condition  secondary  to  disturbance  of  the  rumen  and 
reticulum,  or  on  the  other  hand  consecutive  to  inflammatory  states  or 
to  modifications  in  the  secretion  of  the  abomasum  (dyspepsia),  the 
diagnosis  does  not  present  insuperable  difficulties. 

The  prognosis  is  only  grave  when  the  primary  acute  or  chronic 
conditions  of  the  other  gastric  compartments  are  serio.us. 

The  lesions  comprise  abnormal  vascularity  of  the  mucous  membrane 
and  desquamation,  and  even  gangrene,  of  the  leaves.  The  partially 
digested  food  is  not  passed  on,  becomes  dry  and  hard,  and  in  time 
aggravates  the  local  condition. 

The  treatment  does  not  essentially  differ  from  that  of  other  gastric 
inflammations.  The  object  to  be  attained  is  to  evacuate  as  completely  as 
possible,  not  only  the  omasum,  but  all  the  gastric  reservoirs,  for  which 
purpose  one  may  freely  administer  demulcent  drinks — linseed  gruel, 
bran  mashes  and  lukewarm  liquids  containing  laxatives.  At  first  such 
alkaloids  as  arecolin  and  pilocarpine  may  be  subcutaneously  injected 
to  ensure  energetic  and  speedy  evacuation. 

Later  on  slightly  stimulant  aromatic  infusions,  like  infusions  of  sage, 
peppermint,  hyssop,  thyme,  etc.,  stimulate  the  functions  of  the  stomach 
and  hasten  the  return  of  normal  conditions. 

ACUTE     GASTRITIS. 

The  term  "  acute  gastritis,"  sometimes  "  gastro-enteritis,"  is  used 
in  bovine  pathology  to  indicate  inflammation  of  the  abomasum.     If  this 


ACUTE   GASTRITIS.  189 

inflammation  is  confined  to  the  superficial  epithelial  layers  it  is  defined 
as  superficial  catarrh  of  the  abomasum ;  if,  on  the  contrary,  it  extends  to 
the  deep  epithelium  of  the  gastric  glands  and  to  the  mucous  corium,  it 
is  termed  deep-seated  gastritis. 

Clinically  it  is  impossible  to  make  these  distinctions.  We  simply 
recognise  degrees  of  gravity,  and  only  in  this  way  can  one  diagnose 
acute  gastritis,  phlegmonous  gastritis,   ulcerative   gastritis,   etc. 

Causation.  The  abomasum  frequently  becomes  inflamed  as  a  conse- 
quence of  irritant  foods,  apart  altogether  from  lesions  of  the  rumen  or 
reticulum,  the  mucous  membrane  lining  the  abomasum  being  so  much 
more  delicate  than  that  of  either  of  the  two  first  comi^artments. 

Irritant  plants,  parasites,  acid  drinks,  very  cold  water,  certain  acid 
or  toxic  industrial  residues  like  mouldy  brewers'  grains,  fermented 
vegetable  pulp,  decomposed  beet,  etc.,  and  mouldy  or  spoilt  forage  of 
any  kind  may  all  produce  acute  gastritis. 

Intense  feeding — i.e.,  feeding  with  farinaceous  materials,  with  large 
quantities  of  beans,  roots,  peas,  given  regularly — may  also  cause  gastritis 
by  overtaxing  the  functions  of  the  organ.  Frozen  or  fermented  roots 
and  sudden  changes  in  feeding  produce  similar  results.  Chills  have  also 
been  blamed,  but  it  is  probable  that  they  only  act  as  favouring  causes. 

Symptoms.  It  is  necessary  to  consider  these  very  carefully  in  order 
to  arrive  at  a  correct  diagnosis. 

Inflammation  of  the  abomasum  is  attended  with  moderate  fever, 
diminution  in  appetite,  irregularity  in  rumination  and  some  tension  of 
the  rumen,  without,  however,  true  tympanites. 

At  first  the  bowels  are  constipated,  but  in  time  foetid  diarrhoea  sets 
in.  Examination  of  the  digestive  apparatus  on  the  left  side  and  in  the 
right  posterior  abdominal  region  reveals  nothing  abnormal,  but  pressure 
over  the  lower  portion  of  the  abdomen  and  along  the  cartilages  of  the 
right  hypochondriac  region  produces,  on  the  contrary,  well-marked  pain. 
This  region  corresponds  to  the  position  of  the  abomasum. 

The  conjunctiva  appears  reddish  yellow,  as  in  most  visceral  inflam- 
mations. 

Some  authors  have  described  attacks  of  extreme  excitement,  but 
these  are  no  more  pathognomonic  than  is  grinding  of  the  teeth,  which 
is  a  constant  symptom,  or  the  metallic  sound  noted  on  auscultation 
of  the  rumen.  This  sound  occurs  in  all  cases  of  inertia  of  the  rumen, 
and  indicates  distension  and  emptiness  of  the  viscus  (acute  peritonitis, 
chronic  adhesive  peritonitis,  inflammation  of  the  reticulum  as  a  conse- 
quence of  the  presence  of  foreign  bodies). 

Dull  colic  and  groaning  are  not  uncommon.  Finally,  Thierry  and 
others  have  all  mentioned  an  alliaceous  smell  of  the  eructations  as 
pathognomonic. 


190  ACUTE    INFLAMMATION   OF   THE   GASTRIC   COMPARTMENTS. 

Acute  gastritis  develops  regularly  in  ten  to  fifteen  days,  after  which 
the  symptoms  diminish  and  disappear,  giving  place  to  normal  health.  In 
grave  cases,  despite  proper  treatment,  acute  gastritis  more  frequently 
ends  in  a  chronic  condition,  finally  leading  to  gastric  atrophy,  and  the 
insufficient  secretion  of  hydrochloric  acid,  with  all  the  consequences  of 
these  conditions.  The  glands  of  the  stomach  degenerate ;  the  secretion 
hecomes  abnormal  and  dyspepsia  is  set  up. 

Diagnosis.  The  diagnosis  is  rather  difficult,  for  the  condition  is  very 
apt  to  be  confused  with  primary  dyspepsia,  or  with  inflammation  of  the 
gastric  compartments.  It  might  also  be  mistaken  for  acute  enteritis  of 
the  first  part  of  the  small  intestine ;  but  as  gastritis  is  very  often  compli- 
cated with  duodenitis,  such  a  mistake  is  without  serious  consequences. 

Prognosis.  The  prognosis  is  grave,  not  because  death  is  a  frequent 
termination,  but  because  the  disease  very  often  leads  to  chronic  incurable 
lesions. 

The  lesions  consist  of  congestion  of  the  vascular  network  of  the 
mucous  and  subepithelial  coats,  serous  infiltration  of  the  corium  and 
submucous  connective  layers,  desquamation,  and  later  in  excessive 
proliferation  of  the  epithelium. 

When  the  inflammation  is  deep  seated  the  epithelium  of  the  gastric 
glands  becomes  swollen  and  cloudy,  and  undergoes  a  kind  of  atrophic  de- 
generation. In  very  grave  cases,  petechia,  superficial  capillary  haemor- 
rhages, and  slight  ulceration  may  be  noted.  The  mucous  folds  are 
always  thickened  and  infiltrated. 

Treatment.  In  cases  of  gastritis  or  acute  gastro-duodenitis  mode- 
rate bleeding  (three  to  four  quarts)  and  local  stimulation  were  formerly 
recommended.  This  practice  certainly  has  its  advantages,  provided  it  is 
not  pushed  to  excess.  Sinapisms  give  good  results,  but  as  they  must  be 
left  in  position  for  a  considerable  time,  it  is  often  better  to  apply  vesicants 
over  the  lower  right  hypochondriac  region.  At  first  purgatives  are  useful, 
because  they  unload  the  digestive  tract,  arrest  the  organic  fermentation 
which  results  from  stagnation  in  the  movement  of  food  along  the  alimen- 
tary tract,  and  diminish  the  tendency  to  intoxications  or  infections. 

At  a  later  stage  small  doses  of  laxatives  and  bicarbonate  of  soda  should 
be  given  daily,  the  diet  being  of  an  emollient  character,  and  consisting  of 
milk,  starchy  or  farinaceous  foods,  and  small  quantities  of  good  hay. 

Linseed,  bran,  cooked  grain,  decoctions  of  pellitory,  barley  and 
various  cereals  may  also  be  administered  with  advantage. 

CATARRHAL  GASTRITIS  IN  SWINE. 

Definition.  Inflammation  of  the  gastric  mucosa,  with  muco-purulent 
discharge. 


ULCERATIVE    GASTRITIS.  191 

The  causes  comprise  irritants,  fermented  or  putrid  swill,  decomposed 
food,  excess  of  brine,  alkalies  (washings  from  table  dishes,  hotels,  etc.), 
gastric  parasites. 

The  condition  occurs  also  in  hog  cholera,  swine  plague,  rouget,  etc. 

The  chief  symptoms  are :  Inappetence,  vomiting,  uneasiness,  colic, 
constipation  or  diarrhoea,  fever,  stiffness,  tense  and  tender  abdomen, 
arched  back,  frequent  grunting,  limpness  of  the  tail.  Sudden  vomiting 
may  bring  about  a  rapid  recovery. 

Treatment  calls  for  a  complete  change  of  food,  which  may  include 
freshly  cooked  roots,  linseed  or  meal,  butter  milk,  boiled  milk,  etc. 

As  an  emetic  30  grains  of  ipecacuanha  may  be  given.  Constipation 
can  be  relieved  by  a  dose  of  calomel  or  jalap.  If  diarrhoea  is  persistent 
small  doses  of  grey  powder  should  be  given,  and  to  combat  the  irritation  of 
the  gastric  mucous  membrane  bismuth  subnitrate  is  also  useful. 

The  piggery  should  be  cleansed  and  disinfected,  and  the  litter  frequently 
changed. 

ULCERATIVE    GASTRITIS. 

Ulcerative  gastritis  (ulcer  of  the  abomasum)  is  recognised  after  death, 
but  hitherto  it  has  been  impossible  to  so  clearly  identify  the  symptoms  as 
to  permit  of  diagnosis  during  the  animal's  life.  In  has  been  found 
after  death  in  adults  and  in  calves  (Ostertag). 

Causation  and  Pathogeny.  The  cause  of  gastric  ulceration  is 
decidedly  obscure,  though  we  know  that  certain  forms  occur  during 
infectious  diseases  like  cattle  plague,  foot-and-mouth  disease,  gangrenous 
coryza,  and  as  a  consequence  of  certain  direct  local  infections ;  other 
forms  result  from. the  administration  of  drugs;  and  finally  some  are  of 
secretory  origin. 

In  human  medicine  at  the  present  day  there  is  a  tendency  to  refer 
the  development  of  round  ulcer  and  ulcerative  gastritis  to  the  secretion  of 
an  excess  of  hydrochloric  acid.  Probably  the  same  cause  may  be  at  work 
in  domestic  animals,  but  the  proof  has  not  yet  been  given. 

With  regard  to  the  pathogeny,  the  theories  of  embolism  or  of  throm- 
bosis of  capillary  vessels  find  favour  with  few  authorities  at  the  present 
day.  Yet  these  explanations  are  logical  enough,  for  if  we  prevent 
physiological  irrigation  of  any  given  part,  it  is  possible  to  conceive  that 
ulcer  formation  may  follow  from  auto-digestion,  i.e.,  from  the  simple 
action  of  the  gastric  juice  on  a  surface  which  is  no  longer  protected. 

The  theory  of  microbic  origin  has  been  advanced  ;  but  although  it  may 
be  accepted  in  relation  to  the  intestine,  where  the  most  varied  organisms 
abound,  it  is  scarcely  so  applicable  to  the  stomach,  in  which  acidity  is 
always  very  marked  and  must  exercise  a  very  energetic  antiseptic  action. 
In  sucking  calves,  however,  this  theory  appears  the  most  plausible. 


192  ACUTE    INFLAMMATION    OF   THE   GASTRIC   COMPARTMENTS. 

It  is  quite  certain  that  ulceration  may  result  from  the  unwise  use 
of  drugs,  like  tartar  emetic  or  arsenious  acid,  especially  if  these  be 
administered  for  long  periods ;  but  such  ulceration  always  occurs  at  the 
same  points,  viz.,  at  the  deepest  portion  of  the  rumen,  reticulum,  or 
abomasum. 

On  the  other  hand,  ulceration  due  to  secretory  disturbance  occurs  at 
different  points,  and  the  figure  opposite  shows  that  the  mucous  folds 
themselves  may  be  injured  and  perforated. 

Lesions.  Ulceration  of  the  abomasum  varies  in  severity.  The  case 
referred  to  showed  excavated  ulcers  from  the  site  of  which  a  portion 
or  the  whole  of  the  epithelium  and  glandular  layer  had  been  shed ;  true 
round  ulcers,  which  had  destroyed  the  entire  depth  of  the  mucous  mem- 
brane and  had  produced  chronic  inflammation  and  sclerosis  of  the  muscular 
layer ;  and  finally  perforations  resembling  cleanly  punched-out  holes. 

The  Symptoms  are  those  of  a  mild  form  of  ordinary  acute  gastritis, 
without  marked  fever,  and  without  special  injection  of  the  conjunctiva. 
The  appetite  is  diminished  and  irregular,  but  more  as  a  consequence  of 
excessive  reHex  sensibility  of  the  injured  organ  than  from  absence  of 
hunger.  This  excessive  reflex  sensibility  of  the  abomasum  causes  relative 
or  absolute  gastric  intolerance,  so  that  only  a  small  amount  of  the  food 
ingested  passes  towards  the  intestine. 

Absolute  intolerance  on  the  part  of  the  abomasum  may  even  occur, 
as  in  a  case  described  by  Moussu  in  1895,  which  produced  a  very  special 
form  of  impaction  of  the  rumen,  absolutely  different  from  primary 
impaction. 

Intolerance  of  the  abomasum  for  food  already  ingested  and  rumi- 
nated may  extend  to  the  omasum.  Peristalsis  of  the  rumen  then  ceases, 
and  slight  tympanites  occurs.  The  most  ciiaracteristic  condition  is  the 
existence  of  obstinate  constipation.  If  ulceration  takes  place  without 
producing  any  important  vascular  lesion,  which,  however,  is  rare,  the 
faeces  are  hard  and  coated,  but  without  other  peculiarity ;  if,  however 
(and  this  appears  to  be  the  rule),  local  haemorrhage  occurs,  the  extra va- 
sated  blood  is  modified  by  the  gastric  and  intestinal  juices,  and  the  faeces 
appear  of  a  black,  tarry  colour.  This  coloration  is  very  significant, 
and  differs  from  that  produced  by  the  bile.  It  occurs  only  in  gastric 
haemorrhage,  and  at  intervals. 

Diagnosis.  The  diagnosis  of  gastric  ulcer  is  difficult,  and  can  only  be 
arrived  at  with  confidence  when  the  above-mentioned  coloration  of  the 
faeces  can  be  detected. 

Prognosis.  From  an  economic  standpoint  the  prognosis  is  grave.  The 
patient  may  recover ;  the  ulcers  may  heal,  but  cicatrisation  is  always  pro- 
longed, and  as,  on  the  other  hand,  the  glandular  apparatus  of  the  abomasum 
is  generally  more  or  less  injured,  complete  recovery  is  impossible. 


ULCERATIVE  GASTRITIS. 


193 


Fig.  70. — Ulcerative  gastritis.  1,  Typical  round  ulcer;  2  and  3,  ulcers  perforating 
folds  of  the  abomasum  ;  4,  5,  and  6,  old-standing  ulcers  with  sclerosis  of  the  walls 
of  the  abomasum  and  adhesive  perigastritis. 


D.C. 


194  CHRONIC    INFLAMMATION    OF   THE   GASTRIC   COMPARTMENTS. 

Treatment  should  be  directed  towards  checking  haemorrhage,  dimin- 
ishing intolerance  to  food,  and  assisting  the  healing  of  the  lesions. 
These  objects  are  facilitated  by  prolonged  complete  rest  in  the  stable,  by 
injecting  ergotine,  or,  '7  per  cent,  saline  solution,  at  the  time  when  the 
haemorrhage  occurs,  and,  if  possible,  by  placing  the  animals  on  milk  diet 
or  on  emollient  food,  like  gruels,  emollient  infusions,  barley,  milk,  cooked 
roots,  etc. 

Stimulation  over  the  region  of  the  abomasum  is  also  of  value.  At  a 
later  stage,  when  the  acute  symptoms  have  diminished,  Carlsbad  salts, 
in  doses  of  1  to  2  ounces  per  day,  can  be  given.  Bicarbonate  of  soda  is 
also  of  considerable  value. 

CHRONIC     TYMPANITES. 

Chronic  Indigestion— Obstruction  of  the  Abomasum— Chronic  Gastritis — 

Dyspepsia. 

Among  iiathological  conditions  of  the  stomach  in  ruminants  a 
certain  number  are  clinically  marked  by  one  constant  symptom,  viz., 
chronic  tympanites,  a  fact  which  was  formerly  recognised  as  indicative 
of  chronic  indigestion. 

It  is  evident  that  such  titles  have  only  the  signilican.ee  accorded 
them,  and  the  term  chronic  indigestion  used  only  to  mean  that  gastric 
digestion  was  badly  performed,  and  that  the  condition  was  more  or  less 
permanent.  It  being  granted,  on  the  other  hand,  that  the  term  in- 
digestion is  used  to  characterise  temporary  conditions  during  which 
digestion  is  suspended,  and  produces  immediate  disturbance,  it  would 
appear  that  the  term  gastric  dyspepsia  is  more  exact  and  more  in 
conformity  with  the  present  state  of  our  knowledge  of  general  physio- 
logy. In  studying  this  question  it  is  clear  a  number  of  facts  still 
require  explanation,  for,  as  has  been  previously  indicated,  we  know 
almost  nothing  concerning  the  variations  in  the  chemical  phenomena 
of  gastric  digestion  under  different  morbid  conditions ;  nevertheless,  the 
dominant  fact,  the  imperfect  or  irregular  digestion,  is  easily  a^jpreciable. 
Future  discoveries  will  no  doubt  enable  us  more  exactly  to  differentiate 
several  dyspeptic  conditions  due  to  chemical  or  mechanical  causes  and 
with  or  without  anatomical  lesions.  At  present  it  is  sufficient  to  indicate 
the  limits  of  inquiry. 

Causation.  The  symptom  of  chronic  tympanites  accompanies  a 
great  number  of  very  different  conditions — some  due  to  disease  of  the 
digestive  tract  itself,  others  to  general  diseases  or  lesions  of  neigh- 
bouring parts.  In  the  latter  cases  the  tympanites  is  only  indicative 
of  secondary  dyspepsia ;  in  the  former,  on  the  other  hand,  the  dyspepsia 
is  primary. 

Secondary   dyspepsia   occurs    very   commonly   during    tuberculosis. 


CHRONIC   TYMPANITES.  195 

diseases  of  the  liver,  subacute  or  chronic  peritonitis,  gestation,  lesions 
of  the  mediastinum,   etc.,  etc. 

(a)  Secretory  or  Chemical  Dyspepsia.  In  primary  dyspepsia  it  is 
impossible  to  discover  any  lesion  sufficient  to  explain  the  disturbance. 
Chronic  tympanites,  for  instance,  follows  prolonged  consumption  of 
rough  or  bad  food  (in  years  when  forage  has  been  scarce  or  winter 
food  has  been  lacking),  and  too  short  a  supply  of  water  for  weeks  in 
succession.  It  also  occurs  as  a  consequence  of  acute  inflammation  of 
one  or  other  of  the  gastric  compartments — rumenitis,  reticulitis,  gas- 
tritis. Sometimes  it  assumes  an  insidious,  slow,  progressive  form, 
without  any  apparent  cause  whatever. 

In  these  various  conditions,  the  mucous  membrane  of  the  gastric 
compartments  suffers  from  the  deferred  results  of  the  bad  feeding 
or  want  of  water.  Its  secretory  powers  and  anatomical  structure  be- 
coming modified,  it  is  no  longer  able  regularly  to  elaborate  the  juices 
necessary  for  digestion,  and  chronic  indigestion,  imperfect  digestion,  or 
dyspepsia  result.  Similar  results  follow  acute  inflammation  of  the 
omasum,  reticulum,  or  rumen.  Integral  rejjair  becomes  impossible. 
Anatomical  injury  is  done,  disturbance  of  secretion  follows,  and  dys- 
pepsia is  a  necessary  consequence. 

(b)  Motor  Dyspepsia.  Finally,  it  would  appear  that  general  bad 
health,  al)stinence  and  exhausting  work,  may  produce  a  form  of  dys- 
pepsia, unconnected  with  secretory  disturbance,  but  resulting  from 
mechanical  disturbance  due  to  general  enfeeblement  and  to  atony  of 
the  muscular  walls  of  the  gastric  compartments.  The  rumen  ceases 
to  perform  its  work  of  mixing  the  food,  the  reticulum  also  acts  badly, 
and  the  abomasum  receives  imperfectly  prepared  material.  The  result 
is  what  might  be  described  as  motor  dyspepsia,  in  o^^position  to  those 
forms  which  are  of  chemical  origin. 

The  condition  may  vary  in  degree,  peristalsis  being  diminished  (one 
contraction  every  two  or  three  minutes  instead  of  two  per  minute),  or 
being  simply  intermittent  and  occurring  only  for  a  few  hours  during 
the  day,  or  finally  being  altogether  suppressed.  Suppression  is  never 
absolute,  but  atony  may  be  so  marked  that  the  mixing  of  the  food  is 
very  imperfectly  performed. 

Symptoms.  The  most  constant  symptom  present  in  all  dyspeptic 
conditions  is  chronic  tympanites,  indicated  by  a  certain  degree  of 
tension  or  by  permanent  dilatation  of  the  rumen. 

Eumination  is  impeded  and  irregular,  the  distended  rumen  loses  its 
power  of  contraction,  and  no  longer  causes  eructation  nor  passes  gas 
into  the  intestine.  It  becomes  progressively  inert,  whether  the  inertia 
be  primary  and  occur  suddenly,  as  a  result  of  some  particular  condition 
of  the  sympathetic  system  (motor  dyspepsia),  or  secondary  and  of  slow 


196  CHRONIC    INFLAMMATION   OF   THE   GASTRIC   COMPARTMENTS. 

development  in  consequence  of  disturbance  in  the  gastric  secretions  and 
of  abnormal  organic  fermentation  (secretory  dyspepsia). 

This  symptom  of  tympanites  is  always  accompanied  Vjy  irregularity, 
diminution,  and  frequently  also  by  depravity  of  appetite. 

Wasting  occurs,  but  to  a  very  varying  degree,  according  to  the 
nature  of  the  primary  condition  and  the  method  of   feeding. 

These  general  symptoms  are  accompanied  either  by  constipation  or 
by  diarrhoea  ;  and  as  stagnation  of  food  leads  to  fermentation,  which 
always  forms  products  differing  from  those  of  normal  digestion — toxic 
materials  in  fact — a  chronic  auto-intoxication  results,  which  in  its 
turn,  if  not  remedied,  becomes  a  cause  of  irritation,  and  aggravates  the 
bad  general  condition. 

In  many  cases  fever  is  absent,  except  during  the  final  complica- 
tions, in  animals  in  the  last  stages  of  wasting;  but  some  signs  always 
exist  on  which  the  diagnosis  may  be  founded. 

The  most  frequent  clinical  type  of  these  dyspeptic  conditions  is 
motor  dyspepsia,  consisting  in  relative  atony  of  the  rumen  without 
disturbance  in  the  secretion  of  the  gastric  mucous  membranes. 
Luckily,  this  is  the  most  easily  curable  form,  and  is  only  marked  by 
distension,  dulness  and   constipation. 

Dyspeptic  diseases  of  secretory  origin  are  little  understood.  Their 
essential  causes  have  been  badly  described,  and  their  clinical  symptoms 
are  ill-recognised. 

We  cannot  prove  whether  the  forms  said  to  be  due  in  man  to  excess 
of  hydrochloric  acid  and  insufficiency  of  hydrochloric  acid  really  occur 
or  are  well  defined  in  domestic  animals :  nor  are  we  better  informed  as 
to  the  exact  part  played  by  the  organic  acid  of  fermentation  (lactic, 
butja-ic,  acetic  acid,  etc.) ;  but  the  most  complete  investigations  which 
have  yet  been  made  justify  our  supposing  there  is  some  parallel. 

Moussu  described  primary  ulcerative  gastritis  in  1895  ;  and  as  this 
form  is  almost  certainly  associated  with  excess  of  pepsine,  the  occur- 
rence of  an  excess  of  hydrochloric  acid  also  seems  possible,  the 
more  so  as  the  symptoms  noted  resemble  the  general  symjDtoms  of 
that  condition — preservation  of  appetite  and  of  the  motor  power  of 
the  rumen,  accumulation  of  food  in  the  rumen  as  a  consequence  of 
reflex  intolerance  of  the  abomasum,  constipation,   and  vomiting. 

In  addition  to  these  two  morbid  conditions,  a  third  occurs  with 
some  frequency.  It  is  characterised  by  chronic  tympanites,  alimen- 
tary diarrhcea  (the  food  being  badly  digested),  and  progressive  wasting. 
This  condition  seems  due  to  an  insufficiency  of  hydrochloric  acid, 
brought  about  by  chronic  gastritis,  the  epithelial  cells  of  the  mucous 
membrane  appearing  incapable  of  producing  sufficient  hydrochloric 
acid  for  digestion. 


CHRONIC   TYMPANITES.  197 

Diagnosis.  In  the  present  state  of  our  knowledge  regarding  diges- 
tion in  ruminants  the  precise  diagnosis  of  these  pathological  conditions 
must  always  remain  difficult ;  but  it  is  indisputable  that  with  the  above 
grouping  of  symptoms  we  are  more  likely  to  succeed  than  by  confining 
ourselves  to  the  diagnosis  formerly  common,  viz.,  that  of  chronic  tym- 
panites or  chronic  indigestion. 

The  difference  between  primary  and  secondary  dyspepsia  should  always 
be  borne  in  mind,  and  careful  examination  will  often  reveal  the  special 
condition  which  has  served  as  the  point  of  departure  for  gastric  disturb- 
ance. Thus  generalised  tuberculosis,  or  tuberculosis  of  the  liver  or 
mediastinum,  should  always  be  sought  for,  and  the  possible  existence 
of  such  conditions  of  the  liver  as  echinococcosis,  cancer  of  the  bile 
ducts,  tumours,  etc.,  and  diseases  of  the  kidneys  should  be  borne  in 
mind.  The  influence  of  gestation,  which  so  frequently  causes  gastric 
disturbance  complicated  with  albuminuria,  should  never  be  over- 
looked, and  in  these  secondary  forms  of  dyspepsia  the  determining 
cause,  and  not  the  objective  symptoms  should  receive  chief  attention. 

Prognosis.  The  prognosis  of  secondary  forms  of  dyspepsia  varies 
with  the  gravity  of  the  primary  disease.  The  prognosis  of  primary 
dyspeptic  conditions  varies  greatly,  and  that  state  in  which  hydro- 
chloric acid   is  too  sparingly  secreted  is  certainly  the  gravest. 

Lesions.  The  lesions  have  not  been  carefully  studied,  but  it  is 
probable  that  in  many  cases  they  might  afford  a  key  to  the  symptoms 
noted.  Like  all  mucous  lesions,  they  are  difficult  to  demonstrate 
histologically.  Infiltration  and  thickening  of  the  mucous  corium  and  sub- 
mucous layers  have  been  described.  Such  lesions  indicate  nothing ;  but 
in  some  cases  new  growths  have  been  found  in  the  gastric  compartments 
or  contractions  about  the  pyloric  orifice,  the  essential  importance  of 
which  cannot  be  doubted. 

Treatment.  If  our  knowledge  is  still  insufficient  to  enable  us  pre- 
cisely to  diagnose  what  we  have  termed  "  gastric  dyspepsia,"  or  what  is 
still  currently  described  as  "  chronic  dyspepsia,"  the  difficulty  is  even 
greater  when  attempting  to  lay  down  lines  of  treatment,  because  of  the 
lack  of  known  facts  and  the  want  of  a  base  for  reasoning.  Thus  we  find, 
without  being  able  to  explain  why,  that  some  prescribe  tartar  emetic, 
others  rapid  and  energetic  purgatives,  others,  again,  laxatives ;  whilst 
German  authors,  apparently  without  any  justification,  recommend  oil 
of  turpentine.  It  seems  to  us,  however,  that  one  might  do  better  than 
this  and  attempt  to  lay  down  some  rational  indications  for  treatment. 

(a)  In  cases  characterised  only  by  chronic  tympanites,  without  diar- 
rhoea, without  manifest  constipation  (motor  dyspepsia),  and  without  any 
other  apparent  organic  disturbance,  drugs  calculated  to  stimulate  peri- 
stalsis of   the   rumen    seem   indicated.     The  most  promising  comprise 


198  CHRONIC    INFLAMMATIOX   OF   THE   GASTRIC    COMPARTMENTS. 

ipecacuanha  in  doses  of  1  to  2  drams  per  day,  tincture  of  nux  vomica  in 
similar  doses,  powdered  nux  vomica  in  doses  of  45  to  75  grains,  and 
laxatives  like  Carlsbad  salts  in  doses  of   8  to  10  drams. 

Little  by  little  peristalsis  returns,  becomes  regular,  and  the  chronic 
tympanites  disappears  for  good.  This  is  frequently  the  case  during 
gestation,  when  the  condition  simply  consists  in  motor  dyspepsia  without 
anfemia. 

(/>)  If,  on  the  contrary,  chronic  tympanites  is  accompanied  by 
constipation,  and  the  faeces  are  hard  or,  as  is  usually  the  case,  covered 
with  mucus,  suggesting  the  probability  of  excess  of  hydrochloric  acid, 
salines  are  indicated — not  to  the  point  of  producing  purgation,  which 
would  not  lead  to  any  lasting  improvement,  but  still  as  laxatives,  con- 
tinued daily  for  ten,  fifteen,  or  twenty  days,  or,  if  necessary,  even  longer. 

Carlsbad  salts  in  doses  of  8  to  10  drams,  or  one-ounce  doses  of  sulphate 
of  sodium  associated  with  2^  drams  of  bicarbonate  of  potash  after  each 
meal,  are  to  be  recommended  in  preference  to  bicarbonate  of  soda  alone, 
because  they  act  on  the  secretions,  on  the  muscular  system,  and  also  on 
the  liver. 

(f)  Finally,  when  chronic  tympanites  is  accompanied  by  diarrhoea, 
a  condition  which  usually  indicates  insufficient  secretion  of  hydrochloric 
acid,  the  administration  of  that  acid  tends  to  arrest  or  check  organic 
fermentation  and  to  facilitate  digestion  in  the  abomasum  by  supple- 
menting the  diminished  physiological  secretion.  The  dosage  is  an 
important  point.  At  first  small  quantities  should  be  given,  2J  drams 
per  day,  divided  into  two  doses  and  freely  diluted  in  the  drinking  water  ; 
but  this  amount  may,  if  necessary,  afterwards  be  doubled  or  trebled.  The 
drinking  water  is  not  rendered  irritant  by  these  doses,  for  it  is  admitted, 
and  Moussu  has  confirmed  the  fact  by  analysis,  that  the  quantity  of 
HCl  in  the  gastric  juice  may  rise  as  high  as  "2  to  '3  per  cent.  Chloride 
of  sodium,  the  excito-secretory  action  of  which  on  the  gastric  mucous 
membrane  is  well  known,  may  be  given  for  long  periods  in  doses  of 
1   to  1^   ounces  per  day. 

In  these  various  chemico-pathological  states  the  food  should  receive 
the  closest  attention.  The  forage,  which  should  be  good,  ma}'  be  supple- 
mented by  the  addition  of  cooked  roots,  demulcent  drinks,  and,  if 
possible,  milk. 

GASTRIC    DISTURBANCE    DUE    TO    FOREIGN    BODIES. 

These  morbid  conditions  are  extremely  complex,  but  the  facts  that 
they  are  due  only  to  one  cause,  and  that  they  possess  certain  symptoms 
in  common,  permit  of  a  certain  grouping.  It  would  obviously  be 
illogical  to  speak  of  traumatic  indigestion  of  the  rumen,  reticulum,  and 
abomasum,  as  has  been  done  in  more  than  one  book  on  this  subject ;  for 


GASTRIC   DISTURBANCE   DUE   TO    FOREIGN   BODIES,  199 

the   gastric    disturbances    described   below    should    be    considered    as 
complications,  and  not  as  diseases. 

Causation.  In  young  animals  foreign  bodies  may  be  composed  of 
hairs,  wool,  bristles,  cotton,  and  clover  hairs. 

Hair  balls  are  common  in  the  rumen,  and  are  sometimes  met  with  in 
the  fourth  stomach.  They  cause  irritation,  indigestion,  sometimes  pyloric 
obstruction,  dilatation,  and  eventually  death. 

Wool  balls  in  lambs,  bristle  balls  in  young  pigs,  cause  much  gastric 
irritation.  Cotton  balls  occur  in  lambs  fed  on  cotton-seed  cake ;  the  fibre 
constitutes  a  foreign  body.  The  hairs  of  clover  leaves  may  form  a  ball 
in  the  abomasum  of  lambs. 

Under  the  influence  of  depraved  appetite  animals  of  the  bovine 
species  consume,  apart  from  their  regular  food,  the  most  varying  sub- 
stances, such  as  linen,  fragments  of  wood,  nails,  stones,  gravel,  sand,  etc. 
Moreover,  forage,  even  when  of  good  quality,  often  contains  foreign 
bodies  like  nails  and  pins  (when  the  fields  are  near  factories),  sewing  or 
knitting  needles  (when  the  animals  are  looked  after  by  women),  frag- 
ments of  iron  wire  derived  from  bales  of  compressed  forage,  etc.,  etc. 
The  ingestion  of  such  objects  is  followed  by  various  consequences,  which 
may  be  studied  in  three  divisions,  in  the  first  of  which  the  foreign  object 
is  soft  in  character,  in  the  second  is  blunt  at  one  extremity  and  pointed 
at  the  other,  and  in  the  third  is  pointed  at  both  ends. 

(1.)  Soft  objects.  The  movements  of  the  rumen,  the  warmth  and 
the  action  of  the  digestive  fluids,  may  cause  soft  objects  to  be  broken 
up ;  the  disturbance  they  produce  is  then  insignificant. 

Of  such  substances,  however,  some  are  quite  incapable  of  digestion 
(clothing,  sacks,  linen,  etc.),  and  may  produce  obstructions  ;  others  are 
both  indigestible  and  heavy  (gravel  and  sand),  and  may  fall  into  the 
depressions  of  the  compartments,  where  they  remain,  or,  if  passed  into  the 
reticulum,  may  become  arrested  in  the  deepest  lying  jjart.  They  then 
produce  atony  of  the  muscular  coats,  slowing  of  peristaltic  movements, 
diminution  in  the  frequency  of  eructation,  and,  as  an  additional  conse- 
quence, chronic  tympanites,  sometimes  visible  at  the  flank. 

The  symptoms  are  vague  and  common  to  a  number  of  the  digestive 
diseases  already  described.  The  animals  masticate  without  having  any- 
thing in  the  mouth ;  rumination  becomes  irregular  or  is  altogether  sup- 
pressed, but  this  is  not  characteristic,  being  a  symptom  common  to 
many  visceral  diseases. 

Later,  as  a  result  of  auto-infection,  diarrhoea  sets  in  ;  under  the 
influence  of  abnormal  fermentation  in  the  gastric  compartments  the 
eructations  become  foetid ;  the  animals  fall  into  a  condition  of  marasmus. 
Death  usually  results  after  a  varying  time — when  large  quantities  of 
foreign  substances  have  been  ingested,  in  twenty  to  thirty  days. 


200  CHRONIC   INFLAMMATION   OF   THE   GASTRIC   COMPARTMENTS. 

The  diagnosis  chiefly  rests  on  the  history,  and  can  only  he  of  a 
confident  character  when  one  knows  what  quantity  and  what  kind  of 
foreign  hody  has  heen  swallowed. 

The  prognosis  is  grave,  hecause  the  animal  usually  dies  of  pro- 
gressive exhaustion. 

Treatment.  There  is  only  one  rational  form  of  treatment — viz., 
gastrotomy,  followed  hy  examination  of  the  rumen  and  reticulum  and 
removal  of  the  foreign  hody.  Before  undertaking  operation  the  sui^eon 
should  he  fully  informed  as  to  the  cause  and  the  prohahle  results  to  be 
expected. 

(2.)  Foreign  bodies  with  one  pointed  extremity.  These  usually  con- 
sist of  large-headed  nails,  or  fragments  of  iron  wire  rolled  up  at  one  end, 
which  have  been  swallowed  during  primary  mastication  along  with 
forage. 

When  ingested,  they  may  become  implanted  at  any  point  in  the 
gastric  apparatus  without  necessarily  penetrating  deeply.  When  fixed 
across  the  division  of  the  reticulum,  they  cause  slowing  of  its  physio- 
logical action.  Should  they  penetrate  the  wall  either  of  the  reticulum 
or  of  the  rumen,  they  may  attack  on  the  right  the  liver,  or  on  the  left 
the  diaphragm  or  spleen,  producing  suppurating  hepatitis,  splenitis,  or 
respiratory  disturbance.  The  hypochondriac  region  then  appears  sensi- 
tive. The  muscular  portion  of  the  diaphragm  is  partly  paralysed,  and 
costal  respiration  set  up,  while  frequent  coughing  of  reflex  origin  is  pro- 
voked by  irritation  of  the  pneumo-gastric  and  diaphragmatic  nerves,  and 
may  give  rise  to  suspicion  of  some  thoracic  disease,  from  which,  however, 
it  is  distinguished  by  the  absence  of  discharge,  expectoration,  and  pul- 
monary symptoms. 

Finally,  if  implanted  in  the  lower  wall  or  sides  of  the  rumen  or 
reticulum,  foreign  bodies  may  carry  with  them  infectious  agents  and 
set  up  localised  or  generalised  peritonitis. 

Early  diagnosis  is  a  matter  of  great  difficulty,  as  it  can  only  rest  on 
the  diaphragmatic  disturbance  or  on  the  symptoms  of  peritonitis. 

Lesions.  Small-sized  sharp  bodies  cause  lesions  of  trifling  extent, 
which  in  most  cases  are  only  indicated  by  retardation  of  movement  of 
the  gastric  compartments,  between  which  and  the  diaphragm,  and  be- 
tween the  diaphragm  and  the  posterior  portions  of  the  lung,  various 
adhesions  are  set  up.  In  such  cases  the  peripheral  inflammation  ends 
by  producing  a  fibrous  sleeve,  which  prevents  the  pleural  cavity  becoming 
infected.  Other  cases  show  patches  of  adhesive  peritonitis  or  signs  of 
generalised  peritonitis,  the  real  cause  of  which  often  evades  discovery 
during  life. 

Treatment.  Gastrotomy  is  the  sole  means  of  eftecting  a  cure,  but  we 
are  forced  to  admit  that  it  only  gives  good  results  when  the  operator 


GASTRIC   DISTURBANCE   DUE   TO    FOREIGN   BODIES.  201 

knows  what  he  is  trying  to  find.  Without  this  information  he  acts  in  the 
dark,  is  obhged  to  abandon  himself  to  chance,  and  although  luck  some- 
times favours  him,  it  more  often  leaves  him  in  the  lurch. 

(3.)  Foreign  bodies  pointed  at  both  ends.  Bodies  like  needles,  pins, 
straight  fragments  of  iron  wire,  knitting-needles  and  broken  hairpins, 
become  implanted  in  the  gastric  walls  and  travel  in  the  most  diverse 
directions,  in  obedience  to  the  varied  movements  of  the  organ  injured. 
They  produce  results  similar  to  those  just  described.  Most  frequently 
they  fall  into  the  lower  part  of  the  gastric  compartments,  pass  near  the 
ensiform  cartilage,  between  the  pleura  and  the  triangularis  sterni  into 
the  thickness  of  this  muscle,  or  into  the  mediastinum,  and  there  produce 
either  an  abscess  in  the  region  of  the  ensiform  cartilage,  an  abscess  of 
the  thoracic  wall,  or  a  collection  of  pus  in  the  sub-pericardial  or  sub- 
pleural  region  (pseudo-pericarditis).  They  may  even  reach  the  peri- 
cardium, causing  pericarditis,  and  sometimes,  when  adhesions  are  set  up 
between  the  heart  and  pericardial  sac,  carditis. 

By  deviating  to  the  right  or  left,  the  foreign  body  may  produce 
pleurisy  or  even  pneumonia.  If  it  moves  towards  the  right,  it  involves 
the  liver  and  produces  suppurative  hepatitis  ;  if  to  the  left,  suppurative 
splenitis.  Travelling  in  a  downward  direction,  it  encounters  the  abdo- 
minal wall,  and  after  producing  an  abscess  may  be  eliminated  ;  passing 
backwards,  it  falls  into  the  peritoneum,  and  may  lead  to  peritonitis.  In 
those  exceptional  cases  in  which  foreign  bodies  reach  the  abomasum 
they  generally  become  implanted  towards  the  greater  curvature,  pro- 
ducing in  the  abdominal  wall  an  abscess  which  breaks  externally,  and 
through  which  the  foreign  body  is  discharged  ;  gastric  fistula  is  then 
a  common  sequel. 

The  symptoms  vary,  according  to  the  complications.  The  earliest 
comprise  digestive  disturbance,  which  coincides  with  the  passage  of  the 
sharp  object  through  the  rumen  or  reticulum,  and  depends  on  whether 
such  passage  produces  local  peritonitis  and  pain,  rendering  movement  of 
these  compartments  impossible.  Later,  when  the  diaphragm  has  been 
penetrated,  respiratory  disturbance  occurs,  and  is"  succeeded  by  apparent 
improvement,  which  in  its  turn  may  be  followed  by  the  occurrence  of 
pericarditis,  pleurisy,  or  abscess  formation. 

In  other  cases  where  suppurative  hepatitis  or  splenitis,  or  even 
peritonitis  may  be  present,  the  symptoms  are  extremely  vague  and  very 
difficult  to  refer  to  their  real  cause. 

Diagnosis  is  difficult,  unless  the  owner  is  able  to  supply  exact  infor- 
mation that  at  some  previous  time  the  animal  had  swallowed  such  and 
such  an  object. 

The  prognosis  is  grave,  though  cases  occur  where  a  foreign  body  is 
tolerated,  and  may  for  a  long  time  be  retained  without  producing  accidents. 


202  TUMOURS   OF   THE   GASTRIC    COMPARTMENTS. 

Treatment.  Gastrotomy  should  not  be  performed  unless  the  operator 
is  possessed  of  very  precise  information.  In  such  case  the  rumen  and 
reticulum  should  be  emptied  and  the  foreign  body  sought  for  and  removed. 

When  the  symptoms  strongly  point  to  the  presence  of  a  foreign  body 
exploratory  gastrotomy  may  be  performed,  but  the  operator  will  do  well 
to  employ  the  operation  only  as  a  last  resort. 

]\Iany  complications,  like  septic  peritonitis,  hepatitis,  and  splenitis, 
are  practically  hopeless ;  but  others  show  a  tendency  to  recovery.  This 
is  the  case  when  abscesses  form  in  the  thoracic  or  abdominal  wall,  or 
beneath  the  pleura  or  pericardium.  The  entire  difficulty  consists  in 
diagnosis,  for  when  once  this  is  clearly  defined  intervention  is  fully 
justified.  As,  however,  the  surgical  measures  vary  in  every  case,  the 
exact  course  to  be  adopted  must  be  left  to  the  initiative  of  the  surgeon. 

Tu:\rouRs  of  the  gastric  compartmknts. 

Papillomata  result  from  hypertrophy  of  normal  papilla? ;  they 
resemble  those  of  the  pharynx  and  oesophagus.  The  growth  may  attain 
the  size  of  a  fist.  It  often  resembles  a  cauliflower  in  appearance.  When 
very  large,  such  growths  may  cause  obstruction.  A  very  striking  illus- 
tration of  a  papilloma  of  the  mucous  membrane  is  given  on  p.  180  of 
Moller  and  Dollar's  "  Eegional  Surgery." 

Sarcoma  has  been  noted  by  Paule,  Kitt,  and  Schiitz  as  forming  in 
the  subserous  tissue  of  the  omasum,  and  later  bulging  out  as  a  wounded 
swelling  of  irregular  size. 

Actinomycosis  of  the  abomasum  has  been  reported  by  Professor 
Axe. 


CHAPTER    VI. 
ENTERITIS. 

Enteritis  consists  in  inflammation  of  the  intestine,  or,  more  pre- 
cisely, in  inflammation  of  the  intestinal  mucous  memhrane.  All  the 
constituent  portions  of  the  intestinal  tube  may  be  affected  (duodenum, 
jejeunum,  ileum,  colon,  caecum) ;  but  clinical  distinctions  and  localisation 
of  inflammation  in  the  various  parts  are  very  difficult  in  the  domesticated 
animals,  and  at  present  it  is  impossible  to  describe  with  any  accuracy 
the  differences  between  duodenitis,  enteritis  of  the  jejeunum  and  ileum, 
colitis  or  typhlitis.  Without  doubt  certain  symptoms  suggest  that  some 
regions  are  more  affected  than  others ;  but  clinically  we  are  only  able 
to  distinguish  between  acute  and  chronic  enteritis.  Acute  enteritis  may 
assume  different  forms,  according  to  its  intensity,  rapidity  of  development, 
and  lesions,  so  that  it  is  possible  to  distinguish  between  such  conditions 
as  simple  acute  enteritis  and  haemorrhagic  enteritis. 

Chronic  enteritis,  an  abstraction  founded  on  our  knowledge  of  such 
specific  forms  of  enteritis  as  are  due  to  tuberculosis,  distomatosis, 
helminthiasis,  etc.,  usually  assumes  the  diarrhceic  form. 


ACUTE    ENTERITIS. 

As  acute  enteritis,  whether  localised  in  one  portion  of  the  intestine  or 
involving  the  whole  intestinal  tube,  is  produced  by  varying  causes,  and 
assumes  very  vaiying  degrees  of  intensity,  its  clinical  symptoms  are 
equally  diverse. 

Causation.  The  various  forms  of  enteritis  result  from  two  great 
series  of  causes  :  infections  and  intoxications.  Normally  the  intestine 
contains  an  extremely  large  number  of  different  microbes,  which  may 
prove  of  service  so  long  as  circulation,  secretion,  and  peristalsis  continue 
normal ;  but  as  soon  as  any  perturbation  occurs,  either  in  the  blood 
supply  or  in  the  movement  of  the  bowel,  normal  secretion  is  impeded  ; 
abnormal  organic  fermentation  commences,  producing  irritant  principles 
or  toxins  which  at  once  set  up  local  irritation,  or,  being  absorbed,  produce 
that  complex  of  symptoms  which  we  recognise  as  enteritis,  intoxication 
of  intestinal  origin,  or  even  infection. 


204  feNTERlTlS. 

Bearing  in  mind  these  facts,  we  are  better  able  to  understand  the 
]iart  phi3^ed  by  cold,  by  damaged  fodder,  by  intense,  stimulating  feed- 
ing, or  sudden  changes  in  the  food,  as  well  as  by  the  action  of  drastic 
purgatives,  which  modify  beyond  physiological  limits  the  condition  of 
the  glands,  or  even  cause  local  desquamation  of  epithelium. 

Toxic  substances  or  plants  act  similarly  by  modifying  either  the 
circulatory,  secretory,  or  motor  systems. 

Symptoms.  The  first  appreciable  external  symptoms  appear  to  result 
from  fever — loss  of  appetite,  suspension  of  rumination,  dryness  of  the 
muzzle  and  of  the  mouth,  earthy-red  colour  of  the  conjunctival  mucous 
membrane,  etc. 

On  manipulating  the  left  flank  one  notes  neither  tympanites  nor 
sensitiveness — in  a  word,  there  is  no  indication  of  functional  disturb- 
ance of  the  rumen. 

On  the  right  side,  on  the  contrary,  palpation  causes  the  animal  to 
resist  and  to  show  signs  of  pain.  According  as  this  sensitiveness  is  more 
marked  in  the  middle  or  upper  region  or  towards  the  hypochondriac 
circle,  we  infer  that  the  inflammation  is  most  acute  in  the  large  or 
small  intestine,  either  in  the  middle  portions  or,  again,  in  the  most 
anterior  portion.  The  temperature  always  rises  at  the  commence- 
ment, attaining  103°  to  104°  Fahr.  (39-5°  or  40°  C),  but  rarely  a  higher 
point,  a  fact  which  negatives  the  idea  of  a  rapidly  progressive  infectious 
disease.  Slight  colic  appears,  and  is  accompanied  by  constipation  ;  the 
faeces  are  covered  with  mucus,  or  false  membranes,  or  are  completely 
enclosed  in  fibrinous  tubes.  After  four  or  five  days  the  faeces  change 
in  character.  Constipation  gives  place  to  a  liquid,  blackish,  very  foetid 
diarrhcea.  Finally  the  mouth  exhales  a  stercoraceous  odour,  resulting 
from  foetid  eructation. 

The  passage  of  flat  or  tubular  false  membranes  continues  for  a  certain 
time. 

When  false  membranes  constitute  the  chief  symptom,  the  condi- 
tion is  termed  "  pseudo-membranous,  croupal,  or  diphtheritic  enteritis." 
This  form  is  only  a  variety  of  acute  enteritis,  but  is  grave,  because 
complications  due  to  haemorrhage  or  infection  are  very  liable  to  occur. 

In  certain  cases  movement  causes  groaning.  In  the  slighter  forms 
the  patient  may  recover  spontaneously.  If  fed  with  easily  digested 
materials,  the  symptoms  diminish  in  intensity.  Towards  the  eighth 
day  the  faeces  become  normal,  appetite  and  rumination  reappear,  and 
the  secretion  of  milk  which  had  fallen  off  rises  to  its  normal  amount. 
Eesolution  has  occurred. 

More  frequently,  either  because  the  animals  have  less  power  of 
resistance  or  because  decomposition  is  taking  place  more  actively  in 
the  intestine,  or,  again,   because  intoxication  is  setting  in,  the  disease 


ACUTE   ENTERtTIS.  205 

becomes  aggravated.  Constipation  is  more  marked,  and  the  feces  passed 
are  in  small  masses,  covered  with  layers  of  epithelium,  or  sometimes 
streaked  with  blood.  In  other  cases  the  diarrhoea  becomes  exaggerated 
and  assmiies  a  mucous  or  sero-mucous  character ;  the  temperature  rises, 
and  death  results  from  exhaustion  and  infection,  micro-organisms  passing 
from  the  lumen  of  the  intestine  through  its  walls  and  invading  the 
general  circulation. 

Lesions.  To  study  the  lesions  to  advantage  the  autopsy  must  be 
performed  as  soon  as  possible  after  death. 

In  slight  cases  they  consist  of  trifling  generalised  congestion  of  the 
intestinal  mucous  membrane.  The  points  most  affected  show  infiltra- 
tion of  the  submucous  coat,  and  sometimes  of  the  muscular  coat ;  the 
wall  of  the  intestine  is  double  its  normal  thickness,  but  the  thickening 
never  equals  that  seen  in  cases  of  rapidly  fatal  intestinal  congestion. 

At  a  more  advanced  stage  the  mucous  membrane  clearly  is  inflamed, 
its  surface  is  covered  with  a  fibrous  exudate,  and  the  glandular  and 
epithelial  cells  proliferate,  assume  the  embryonic  form,  and  produce  the 
new  tissue  which  one  recognises  under  the  form  of  false  membranes. 

The  false  membranes  are  generally  but  slightly  adherent,  and  are 
readily  expelled. 

In  other  cases,  however,  they  adhere  firmly,  and  when  detached  by 
the  friction  caused  by  movement  of  semi-digested  food  through  the  bowel, 
produce  rupture  of  capillary  vessels  ;  this  explains  the  presence  of  blood 
streaks  in  the  fffices. 

The  diagnosis  is  relatively  easy,  especially  at  the  onset,  on  account 
of  the  special  character  of  the  fsces  and  the  sensitiveness  of  the  right 
flank. 

The  prognosis  is  seldom  grave.  If  the  enteritis  is  taken  at  the 
beginning,  recovery  is  usual ;  but  if  the  animal  has  been  ill  for  eight 
or  ten  days  and  is  exhausted,  and  if  fever  and  diarrhcea  are  intense,  the 
prognosis  should  be  guarded. 

The  treatment  is  that  of  all  acute  inflammatory  diseases.  Mustard 
plasters  may  he  applied  to  the  chest  and  abdomen  and  left  in  position 
for  some  hours,  or  may  be  repeated.  Some  practitioners  prefer  hot 
blankets  or  dry  friction,  or,  again,  rubbing  with  essence  of  turpentine, 
but  this  substance  should  be  spread  over  large  surfaces,  in  order  to 
prevent  injury  to  the  skin.  Bleeding  is  only  justifiable  in  plethoric 
animals,  and  should  never  be  exhaustive. 

To  relieve  the  digestive  symptoms  purgatives  are  at  first  given,  even 
though  diarrhoea  is  marked  from  the  onset ;  for  purgatives  still  consti- 
tute the  best  intestinal  antiseptics,  because  they  get  rid  of  the  intestinal 
contents  and  microbes.  The  diet  should  be  carefully  selected,  and  may 
consist  of  gruel,  mucilaginous  materials,  linseed  tea,  cooked  roots,  etc. 


206  ENTERITIS. 

Of  drugs,  sulphate  of  sodium  in  doses  of  10  to  15  ounces  is  pro- 
bably the  best.  It  can  gradually  be  replaced  by  2  to  3  drachm  doses  of 
bicarbonate  of  soda  or  of  ordinary  salt  per  day.  Laudanum,  camphor, 
and  bismuth  relieve  persistent  colic  and  diarrhcea.  Pilocarpine,  veratrine 
and  eserine,  though  recommended  by  some  authors,  present  no  advantage 
in  our  opinion.  The  first  two  of  these  substances  certainly  cause  purga- 
tion, but  the  action  is  quite  temporary.  The  last  induces  violent  con- 
traction of  the  striped  muscular  tissue,  and  may  produce  grave  lesions  or 
invagination  when  the  bowel  is  diseased,  thickened  or  infiltrated. 

H.EMORRHAGIC    ENTERITIS. 

This  form  of  enteritis  derives  its  name  from  the  dominant  symptom, 
which  consists  in  the  passage  of  unaltered  or  clotted  blood  in  the  faeces. 
Ill  the  former  case  the  blood  is  bright  in  colour,  as  if  it  came  directly 
from  an  open  vessel.  In  the  second  it  is  coagulated,  and  assumes  the 
form  of  fibrinous  clots,  which  seem  to  result  from  the  superposition, 
in  the  intestinal  tract  of  their  constituent  elements,  viz.,  serum,  blood 
corpuscles,  and  fibrin. 

Causation.  Htemorrhagic  enteritis  is  rarely  seen  except  during  the 
hottest  days  of  summer,  and  in  young  animals  which  have  previously 
shown  nothing  abnormal.  The  high  temperature  seems  to  favour  its 
appearance,  but  is  always  supplemented  by  another  cause,  viz.,  the 
ingestion  of  irritant  food,  particularly  of  weeds  and  toxic  plants  or 
herbage  of  bad  quality ;  amongst  such  may  be  mentioned  dog's  mercury, 
and  plants  of  the  order  Papaveracese,  EuphorbiacefB,  etc.  Otherwise 
the  often  rapid  manner  in  which  the  disease  develops  indicates  toxic 
enteritis. 

In  other  cases,  more  benign  in  appearance,  but  quite  as  grave  in 
reality,  blood  is  passed  continually,  and  the  disease  assumes  a  chronic 
form.  It  is  then  of  parasitic  origin,  and  is  due  to  intestinal  psoro- 
spermosis. 

Symptoms.  The  primary  symptoms  are  similar  to  those  of  acute 
enteritis,  and  consist  of  fever,  dryness  of  the  muzzle  and  of  the  mouth, 
colic  and  constipation.  This  is  soon  followed  by  loose  motions  con- 
taining blood  or  blood  clots,  according  as  the  hfemorrhage  occurs  at  a 
greater  or  less  distance  from  the  rectum.  The  faeces  are  then  ejected 
violently  to  a  considerable  distance,  on  account  of  the  exaggerated 
intestinal  peristalsis. 

The  disease  may  produce  death  in  twenty-four  hours,  though  usually 
the  end  is  deferred  for  several  days,  or,  in  cases  due  to  sporozoa,  for  a 
considerably  longer  time.  In  these  cases  there  is  some  chance  of 
recovery,  provided  that  treatment  be  prompt. 

The  diagnosis  is  very  easy. 


HEMORRHAGIC   ENTERITIS.  207 

The  prognosis  is  in  all  cases  grave. 

The  lesions  are  ill-recognised.  The  animals  die  rapidly,  and  if  not 
immediately  examined  show  no  characteristic  lesions.  The  changes  to  be 
looked  for  consist  in  intense  congestion  or  ulceration  of  the  intestine,  or 
even  in  ulceration  of  arterioles  and  of  arteries  of  considerable  size. 

In  parasitic  enteritis  one  finds  localised  inflammation  and,  in  the 
epithelial  interstices,  sporozoa,  which  cause  the  rupture  of  blood-vessels. 

Treatment.  It  is  necessary  to  act  energetically  from  the  outset, 
and  to  arrest  haemorrhage  by  acting  on  the  intestine,  on  the  vascular 
system,  and  on  the  skin.  Mustard  plasters  or  other  external  stimulant 
applications  are  therefore  indicated.  Internally,  small  doses  of 
astringents  like  tannin,  preparations  of  opium,  25  per  cent,  solution 
of  sulphuric  acid  in  alcohol,  etc.,  are  given  to  produce  constriction  of 
the  vessels,  though  they  seldom  arrest  the  discharge  of  blood  for  long. 
In  most  cases  it  is  necessary  to  have  recourse  to  subcutaneous  injections 
of  ergotine,  in  doses  of  5  to  10  grains  in  young  animals,  and  15  to  45 
grains  in  adults.  The  dose  may  be  given  in  two  parts  to  prevent  an 
unduly  severe  action.  The  smooth  fibres  of  the  small  vessels  are  thus 
directly  excited,  and  haemorrhage  ceases  in  consequence  of  clotting  in 
the  contracted  vessels. 

One  may  give  for  the  same  purpose  injections  of  arseniate  of 
strychnine,  which  has  the  advantage  of  sustaining  the  tone  of  the 
heart  and  preventing  syncope.  The  dose  should  not  exceed  1*5  grains 
in  large  animals. 

Finally,  a  stimulating  diet  containing  milk,  alcohol,  soup,  cooked 
vegetables,  and  small  quantities  of  vegetable  pulp  is  useful. 

With  early  treatment  animals  sometimes  recover  in  a  few  hours. 

Intra-venous  or  subcutaneous  injections  of  physiological  salt  solution 
(2  drachms  of  sodium  chloride  in  one  quart  of  water)  may  prove  of  value 
when  haimorrhage  has  been  abundant  and  vascular  pressure  is  low. 

CHRONIC    ENTERITIS    (CHRONIC    DIARRHCEA). 

Chronic  diarrhcea  is  common  in  byres.  It  appears  suddenly,  often 
fails  to  attract  attention,  and  assumes  the  form  of  simple  diarrhoea,  a 
fact  which  accounts  for  it  frequently  being  described  as  chronic  diarrhcea, 
dysentery,  etc. 

Causation  and  pathogeny.  This  form  of  diarrhoea  occurs  sporadi- 
cally throughout  France,  and  under  exceptional  circumstances  may 
permanently  attack  a  number  of  animals  in  a  given  place. 

The  immediate  cause  is  not  known,  but  without  doubt  the  disease 
is  of  microbic  origin.  Like  Lignieres,  Moussu  at  one  time  believed 
that   this   disease    was   very   probably   identical    with   that    known    in 


208 


ENTERITIS. 


Argentina  under  the  names  of  diarrhcea,  cnteque,  or  bovine  pasteurellosis. 
The  hypothesis  has  not  been  verified,  and  Lignieres'  treatment,  said  by 
him  to  have  succeeded  in  Argentina,  always  failed  in  Moussu's  hand. 

The  only  point  which  seems  admissible  is  that  this  disease,  which 
Moussu  considered  to  have  analogies  with  chronic  sporadic  dysentery 
in  man,   is   due   to  one   or   several    organisms,  which  develop  in   the 

intestine  and  produce  toxins,  causing 
diarrhoea,  without,  however,  marked  in- 
fiammation  of  the  intestinal  mucous 
membrane. 

Symptoms.  The  onset  is  often  over- 
looked. The  diarrhcea  gradually  in- 
creases without  appearing  to  be  very 
serious ;  but  it  persists  in  varying  de- 
grees of  intensity.  The  patients  do  not 
appear  to  suffer,  and  do  not  lose  their 
appetite  or  spirits,  but  in  time  the 
diarrhcea  becomes  exhausting ;  they 
waste,  and  after  some  months  become 
excessively  thin  and  poor. 

Intestinal  peristalsis  becomes  exag- 
gerated without  the  existence  of  colic  or 
tympanites.  The  evacuations  are  fre- 
quent, and  little  by  little  the  abdomen 
retracts,  until,  in  horseman's  parlance, 
"the  belly  is  up  to  the  back,"  even  in 
cows  of  four,  seven,  and  eight  years' 
bearing. 

The  diarrhcea  is  serous,  always  foetid, 
and  without  tenesmus. 

The  ffeces  may  either  be  very  soft 
or  be  passed  in  veritable   jets.     They 
are    always    a    little    discoloured,    and 
frequently  contain  grain  or  undigested 
forage.     They  always  contain  numerous  bubbles  of  gas. 

The  wasting  during  later  periods  of  the  disease  is  absolutely 
characteristic,  and  different  from  that  of  other  wasting  diseases,  such 
as  chronic  broncho-pneumonia,  tuberculosis,  etc.  The  patients  finally 
become  walking  skeletons.  The  red  corpuscles  of  the  blood  progressively 
decrease,  until  the  number  may  fall  as  low  as  800,000  or  even  500,000 
red  corpuscles  instead  of  six  millions,  the  normal  figure.  The  tedenia 
common  to  wasting  conditions  appears,  and  the  animals  die  without 
suffering,  in  a  condition  of  absolute  exhaustion. 


Fig.  71. — Appearance  of  a  patient 
suffering  from  advanced  chronic 
diarrhoea. 


CHRONIC    ENTERITIS    (CHRONIC   DIARRHCEA). 


209 


Fig.  72. — Appearance  of  a  portion  of  the  small 
intestine  in  chronic  diarrhoea. 


ComiDlications  are  rare,  though  occasionally  intestinal  haemorrhage  or 
broncho-pneumonia  occurs.    The  temperature,  which  remains  normal  or 
shows  very  slight  changes  throughout  the  course  of  the  disease,  may  then 
oscillate      between     lOl"" 
and  103°  Fahr.  (38°  and 
39-5°  C). 

Lesions.     At  the  first 
glance  no  lesions  can  be 
detected  on  post-mortem 
examination  except  those 
of     generalised    wasting, 
but  when  the  autopsy  is 
carried    out   immediately 
after    death    all    the    in- 
terior of  the  intestine  appears  affected.     The  mucous  membrane  of  the 
abomasum  and  the  mucous  folds  appear  infiltrated,  thickened,  and  with 
moderate   sub-epithelial  congestion.     The  intestine  seems   friable,  and 
tears  with  the   slightest  traction.     The  sul>epithelial  portions   of   the 

mucous  folds  are 
infiltrated  and  con- 
gested, while  the 
more  prominent 
parts  of  the  folds, 
which  are  exposed 
to  the  friction  of 
semi-digested  food, 
become  eroded. 

Throughout  the 
length  of  the  jejeu- 
num  and  ileum  the 
mucous  membrane 
exhibits  multitudes 
of  small  ulcera- 
tions. 

Histologically, 
the  epithelium  and 
the  glands  seem  atrophied,  without  any  inflammatory  change  having 
occurred  in  the  mucous  or  submucous  coats. 

The  colon  and  the  caecum  show  similar  lesions,  and  in  addition 
brown  deposits  of  pigment  under  the  mucous  membrane  and  along  the 
course  of  the  small  blood-vessels.  This  lesion  resembles  that  found 
in  chronic  dysentery  in  man,  and  suggested  to  Moussu  a  possible 
connection  between  the  two  diseases. 

D.C.  P 


Fig.  73. — Atheromatous  lesions  of  the  aorta  in  chronic 
diarrhoea. 


210  ENTERITIS. 

The  liver  is  less  than  the  normal  size.  In  the  heart  Monssu  has 
seen  one  case  of  sclerosis  of  the  auricles  and  calcareous  infiltration  of 
the  sub-endothelial  lining  of  the  aorta. 

In  several  instances  he  has  noted  calcareous  infiltration  of  the 
mesenteric  lymphatic  gland. 

Diagnosis.  It  is  easy  to  diagnose  this  condition,  and  quite  possible 
to  distinguish  it  from  the  diarrhcea  of  tuberculous  enteritis,  infectious 
hepatitis,  and  other  conditions. 

Prognosis.  The  prognosis  is  very  grave,  and  the  disease  almost 
always  proves  fatal. 

Treatment.  At  the  present  moment  no  curative  treatment  is  kno^Yn. 
Lignieres'  treatment — viz.,  the  injection  of  physiological  salt  solution 
and  serum  from  healthy  oxen,  and  saline  solution  or  defibrinated  blood 
— has  never  given  permanently  successful  results. 

All  the  drugs  usually  employed  against  diarrhoea,  the  antiseptics, 
astringents,  etc.,  fail,  or  confer  merely  momentary  benefit.  Econo- 
mically, nothing  is  to  be  gained  by  keeping  the  patients  alive.  With 
great  care  existence  may  be  prolonged  for  months,  or  even  for  several 
years,  but  the  animals  never  regain  condition,  and  are  never  of  any  use. 

The  most  rapid  and  lasting  good  effects  follow  the  administration  of 
2|  to  8  fluid  drachms  of  hydrochloric  acid  per  day,  given  in  two  portions 
and  very  freely  diluted. 

DYSENTERY    IN    CALVES. 

This  disease  sometimes  appears  on  the  first  day  after  birth,  frequently 
on  the  second  or  third.  It  may  be  mistaken  for  septicaemia  of  umbilical 
origin. 

Symptoms.  The  young  animal  may  be  born  vigorous  and  in  good 
condition,  though  this  is  exceptional.  More  frequently  it  is  puny  and 
below  normal  weight.  The  first  evacuation  (of  meconium)  may  exhibit 
the  diarrhceic  character  ;  in  other  cases  this  peculiarity  only  appears  on 
the  second  or  third  day,  when  half- digested  milk  is  passed.  The  fluid 
is  greyish,  extremely  fcetid,  and  rapidly  becomes  brownish  and  blood- 
stained.    Evacuation  is  frequent  and  accompanied  by  tenesmus. 

The  patients  at  once  become  very  dull,  refuse  to  suck,  and  resist 
efforts  to  feed  them  by  hand.  The  temperature  rises,  and  the  diarrhoea, 
which  at  first  was  of  an  alimentary  character,  becomes  mucous,  serous 
and  blood-stained.  The  little  patients  appear  "tucked  up,"  the  flanks 
sink  in,  the  strength  diminishes,  and  in  twenty-four  hours,  or  two  or 
three  days  at  most,  they  die  of  exhaustion. 

Recovery  is  exceptional,  and  when  the  disease  assumes  this  character 
it  usually  attacks  a  considerable  proportion  of  the  other  animals  in 
the  byre. 


DYSENTERY    IN   CALVES.  211 

Causation.  The  exact  cause  of  this  form  of  dysentery  in  new-horn 
calves  has  not  yet  heen  identified,  but  the  disease  is  undoubtedly  a  microbic 
enteritis,  and  may  even  be  a  primary  septicaemia  of  puerperal  origin. 

For  a  very  long  time  this  dysentery  was  mistaken  for  simple 
diarrhoea,  though  it  exhibits  neither  the  characteristics,  course,  nor 
termination  of  the  latter  disease. 

The  co-existence  of  epizootic  abortion  and  dysentery  in  certain  byres 
has  led  some  authors  to  believe  that  a  connection  exists  between  the 
two  diseases,  and  that  the  young  are  infected  with  dysentery  at  birth. 
Evidently,  intra-uterine  infection  is  not  exceptional,  and  it  seems  quite 
natural  that  the  new-born  calf  may  equally  suffer  when  the  foetal 
envelopes  and  fluids  are  infected  before  parturition.  Epizootic  abortion 
is  probably  not  the  only  disease  which  may  produce  this  condition. 

The  diagnosis  is  very  simple.  The  course  of  the  disease  and  its 
rapid  development  prevent  it  from  being  mistaken  for  ordinary  diarrhoea. 
It  is  more  difficult  to  distinguish  from  septicaemia  of  umbilical  origin, 
although  this  disease  also  has  well-marked  characteristics. 

The  prognosis  is  not  hopeful.  Statistics  show  that  almost  all  the 
affected  animals  die,  and  that  those  exceptional  cases  which  survive 
remain  puny  and  sickly.  There  is  no  economic  advantage  in  attempting 
to  save  them. 

The  mothers  of  affected  calves  seldom  show  any  sign  of  illness, 
though  the  after-birth  is  often  retained. 

Lesions.  The  macroscopic  lesions  are  of  very  trifling  importance 
compared  with  the  gravity  of  the  disease.  The  digestive  tract  appears 
congested  throughout.  The  intestinal  mucous  membrane  is  moderately 
swollen,  but  without  gross  lesions.  The  intestinal  contents  exhale  a 
sickly,  foetid  odour.  The  smaller  vessels  and  capillaries  forming  the 
peripheral  vascular  network  appear  distended,  as  in  septicasmia.  The 
carcases  putrefy  with  extreme  rapidity. 

Curative  treatment  is  very  uncertain.  Varying  results  have  been 
obtained  with  doses  of  4  to  5  drams  of  slight  purgatives  like  boro- 
tartrate  of  potassium,  sodium  sulphate,  and  magnesium  sulphate ; 
small  doses  of  intestinal  antiseptics  like  salicylic  acid,  15-grain  doses  of 
salicylate  of  soda,  45  to  75  grains  of  carbolic  acid,  2  jjer  cent,  carbolic 
solution  in  doses  of  7  to  12  drams ;  1  per  cent.  Lysol  solution  in  doses 
of  2  to  4  ounces;  benzo-naphthol,  lactic  acid  45  to  75  grains,  tar  water, 
lime  water,  etc.  Although  all  these  preparations,  when  carefully  used, 
generally  give  good  results  in  the  early  stages  of  simple  diarrhoea, 
they  appear  to  fail  in  dysentery  of  new-born  calves. 

Prophylactic  measures  are  more  reliable.     They  consist  : 

(1.)  In  scrupulous  disinfection  of  the  byres  when  the  first  case  of 
abortion  occurs  ; 

P  2 


212  ENTERITIS. 

(2.)  In  successively  isolating  cows  which  are  ahout  to  calve  in  a 
small  specially  detached  stable  ; 

(3.)  In  carefully  disinfecting  the  genital  organs  of  cows  which  have 
aborted,  firstly  with  boiled  water  at  a  temperature  of  100°  Fahr.,  and 
then  with  1  per  cent,  iodine  solution. 

Calves  which  are  infected  when  born  cannot  be  saved,  but  abortion 
can  be  prevented  and  dysentery  so  stamped  out. 

DIARRHCEIC    ENTERITIS    IN    CALVES. 

This  disease  is  usually  called  "  simple  sporadic  diarrhoea."  It  may 
appear  at  any  time  before  weaning,  and  can  usually  be  cured  if  treated 
early  before  the  patients  show  bodily  wasting. 

Causation.  Indigestion  from  failure  of  the  abomasum  to  deal  with 
the  milk  usually  precedes  diarrhoeic  enteritis ;  it  may  terminate  without 
complications,  but  very  often  is  followed  by  diarrhoea.  Anything  which 
produces  milk  indigestion,  therefore,  favours  the  occurrence  of  enteritis. 
Such  predisposing  influences  include  over-distension  of  the  abomasum, 
milk  of  bad  chemical  composition,  milk  tainted  by  keeping  or  by  storage 
in  dirty  and  infected  pails,  etc.  The  addition  to  the  milk  of  nutritive 
substances  which  the  abomasum  and  intestine  are  not  yet  capable  of 
digesting,  such  as  wheat,  rye,  barley,  or  maize  meals,  very  often  produces 
diarrhoea  even  when  the  meal  is  well  cooked. 

Chills,  privations,  irregular  feeding,  and  badly-managed  weaning 
may  facilitate  its  development,  but  none  of  these  causes,  however  impor- 
tant they  may  be,  seem  to  play  any  other  part  than  that  of  favouring  tlie 
multiplication  of  the  numerous  varieties  of  microbes  to  be  found  in  the 
intestinal  tract.  Vascular  disturbance  occurs,  either  as  a  result  of  direct 
irritation  of  the  intestinal  mucous  membrane  or  of  the  action  of  toxic 
products  contained  in  milk  which  has  served  as  a  culture  medium  for 
these  microbes ;  this  is  followed  by  secretory  disturbance,  and  the 
intestinal  contents  being  modified  in  character,  the  microbes  normally 
present  undergo  changes  in  number  and  quality.  Inoffensive  organisms 
assume  pathogenic  qualities  and  secrete  toxic  principles,  normal  digestion 
is  disturbed,  the  intestinal  defence  becomes  less  perfect,  toxic  principles 
which  the  liver  is  incapable  of  destroying  are  absorbed,  and  diarrhceic 
enteritis  is  set  up. 

Symptoms.  Diarrhceic  enteritis  appears  during  the  second  week  of 
life,  towards  the  end  of  the  first  month,  or  even  later.  It  is  characterised 
by  the  passage  of  faeces  consisting  of  mucus  and  containing  little  clots 
of  milk. 

This  is  the  first  stage  of  alimentary  diarrhoea,  also  termed  "  white 
diarrhoea"  or  "white  scour."     It  may  prove  unimportant;  it  may  last  a 


DIARRHCEIC   ENTERITIS   IN   CALVES.  213 

day  or  two  and  then  cease.  Most  commonly  diarrhoea  increases  and 
assumes  a  mucous  and  then  a  serous  character,  whilst  the  dejecta  exhale 
a  very  characteristic  repulsive  smell.  The  excrement  becomes  greenish 
brown,  and  after  several  days  or  a  week  or  more  may  appear  blood- 
stained. The  number  of  evacuations  varies  enormously,  depending  on 
the  gravity  of  the  condition.  The  ejected  material  is  irritant,  and  the 
parts  soiled  by  it,  like  the  perineum,  hocks,  and  back  of  the  cannon 
bones,  become  slightly  inflamed  as  though  blistered;  later,  the  hair 
falls  away. 

The  general  health  then  begins  to  suffer.  Fever  remains  moderate, 
but  the  mouth  is  pasty,  the  tongue  coated,  and  the  breath  foetid. 

The  patients  become  thin,  and  lose  their  appetite  and  spirits.  Palpa- 
tion of  the  abdomen,  especially  of  the  right  flank,  is  slightly  painful,  and 
the  pulse  is  accelerated. 

The  diarrhoea  may  spontaneously  diminish  if  the  animal's  constitution 
prove  sufficiently  strong;  but  if  it  follows  its  course,  the  little  patient 
becomes  weaker,  eats  less,  the  evacuations  increase  and  are  accompanied 
by  tenesmus.  In  seven  to  eight  days,  in  rare  cases  in  foui-  to  five,  the 
animal  dies  from  toxi-intoxication  of  intestinal  origin,  or  from  infection 
resulting  from  intestinal  germs,  particularly  the  bacterium  Coll  communis, 
obtaining  entrance  into  the  circulation.  On  the  other  hand,  the  diarrhoea 
may  continue  for  weeks. 

The  diagnosis  is  easy,  and  there  should  be  no  difficulty  in  distin- 
guishing this  disease  from  dysentery  and  from  umbilical  phlebitis, 
which  are  also  accompanied  by  diarrhoea. 

The  prognosis  is  grave,  unless  treatment  is  early  undertaken.  In 
the  latter  case  there  is  a  good  chance  of  recovery. 

Lesions.  The  macroscopic  lesions  are  not  of  much  interest,  being 
confined  to  congestion  of  the  intestinal  mucous  membrane,  superficial 
desquamation  of  the  epithelium,  small  vascular  erosions,  and  general 
wasting. 

The  mesenteric  lymphatic  glands  are  swollen  and  oedematous. 

After  death  from  general  infection,  it  is  not  uncommon  to  find  pleural, 
peritoneal,  and  pericardial  exudation  or  even  endocarditis. 

Even  in  cases  where  no  post-mortem  change  has  had  time  to  occur 
cultures  from  the  blood  yield  varieties  of  the  bacterium  Coll  communis. 

Treatment.  The  meals  should  be  given  at  fixed  hours,  and  regulated 
both  as  regards  quantity  and  quality.  These  precautions  alone  suffice  to 
prevent  the  appearance  of  diarrhoeic  enteritis. 

Curative  treatment  has  every  chance  of  succeeding  when  under- 
taken at  the  outset.  Delafond  and  Trasbot  recommend  mild  purgatives, 
which  act  more  rapidly  than  intestinal  antiseptics.  These  comprise  boro- 
tartrate  of  potash  in  doses  of  4  to  5  drachms,  sodium  sulphate  in 


214  ENTERITIS. 

of  2^  to  4  drachms,  sulphate  of  magnesia,  etc.  By  evacuating  the  howel 
and  removing  a  large  number  of  the  germs  which  have  multiplied  there, 
they  arrest  intoxication  and  prevent  infection.  Nevertheless,  they  should 
not  be  administered  for  long,  and  after  one  or  two  doses  should  be  fol- 
lowed by  antiseptics  like  benzo-naphthol,  in  doses  of  15  to  30  grains,  sali- 
cylic acid  in  doses  of  5  to  10  grains,  or  salicylate  of  soda  45  to  60  grains. 
Mucilaginous  and  sweetened  drinks  containing  lactic  acid  in  doses  of  45 
to  75  grains  per  day  may  be  given  between  the  meals,  or  at  intervals  if 
the  calf  is  sucking. 

Laudanum  in  doses  of  6  to  10  drops  per  day  administered  in  rice 
water,  extract  of  opium,  weak  solutions  of  tannin,  etc.,  are  also  of  value. 
Filliatre  has  successfully  used  tar  water  in  the  first  stages.  The  solution 
consists  of  vegetable  tar  6  drachms,  boiling  water  1  quart.  This  solution 
is  used  tepid  in  the  proportion  of  1  part  to  3  parts  of  warm  milk. 

Decoctions  of  spiked  purple  loosestrife,  willow  bark,  etc.,  are  also  of 
great  value  in  certain  districts. 

The  drug  which  appears  least  dangerous,  however,  is  that  so  often 
successfully  used  in  young  children — viz.,  subnitrate  of  bismuth.  It 
can  be  given  in  doses  of  30  to  45  grains  per  day,  with  lactic  acid  in  doses 
of  75  to  150  grains,  according  to  the  size  of  the  patients.  If  the  animals 
are  greatly  exhausted  and  have  been  ill  for  some  time  there  is  less  chance 
of  recovery,  and  under  these  circumstances  Dr.  Lesage's  anti-colic  serum 
might  be  used. 

It  gives  excellent  results  in  infants,  and  it  has  proved  successful  in 
simple  diarrhcea  of  calves. 


CHAPTER    VII. 
POISONING. 

Accidental  poisoning  is  frequent  in  domesticated  animals.  It  may 
present  no  visible  lesions,  and  it  is  therefore  very  important  to  recognise 
the  symptoms  ^Yhich  indicate  the  secret  lesion. 

POISONING    DUE    TO    FOOD. 

Under  this  title  are  included  all  forms  of  poisoning  resulting  from  the 
iiigestion  of  bad  fodder.  Such  expressions  as  "intestinal  typhus"  and 
"  typhic  gastro-enteritis  "  only  indicate  a  special  stage  in  the  condition, 
which  is  never  twice  the  same. 

Causation.  The  most  important  changes  in  the  food  ingested  do  not 
consist  in  a  mere  modification  in  its  chemical  composition,  but  in  the 
presence  of  various  parasites  which  develop  in  grain  and  forage,  after 
moistening,  or  after  abnormal  fermentation  in  the  interior  of  the  grains. 
These  parasites  are  chiefly  represented  by  fungi  belonging  to  the  genus 
Mucor :  AspevfiUlm  or  PeniciUmm ;  blight — Puccinia  graminis,  Uredo 
linearis;  smut — Tillctia  caries,  Ustilago  segetum,  Ustilago  mayclis ; 
yeasts  of  different  kinds  resulting  from  the  fermentation  of  brewers' 
grains ;  and,  finally,  unrecognised  microbes  which  act  by  means  of  the 
poisons  they  secrete. 

The  symptoms  are  always  very  vague.  At  first  the  only  marked 
symptom  is  loss  of  appetite,  accompanied  by  dryness  of  the  mouth  and 
muzzle,  depression  and  constipation.  The  animals  never  clearly  show 
signs  of  gastro-enteritis  ;  nevertheless,  the  changes  in  general  health 
point  very  clearly  to  a  digestive  origin. 

In  cases  of  acute  poisoning  the  symptoms  develop  rapidly.  Torpor 
becomes  more  marked,  the  movements  of  the  heart  tumultuous,  and  the 
temperature  rises  to  105°  Fahr.  (40'5°  C),  diminishing  later  until  death 
occurs. 

In  chronic  forms  of  poisoning  constipation  is  present  at  first,  but  is 
soon  followed  by  profuse,  foetid,  blackish  diarrhoea,  sometimes  containing 
streaks  of  blood  and  accompanied  by  abdominal  pain. 

In  exceptional  cases  these  digestive  symptoms  are  amplified  by  the 
presence  of  broncho-pneumonia,  pleuro-pneumonia,  nephritis,  and  cystitis, 


216  POISONING. 

as  in  poisoning  by  tannin  and  essential  oils.  These  complications  are 
of  infections  origin. 

In  young  animals,  like  lambs  and  young  pigs,  still  with  their  mothers 
alimentary  intoxication  may  also  occur  though  the  mothers  show  no 
signs  of  illness.  The  passage  of  poisonous  principles  into  the  milk 
cannot  be  disputed.  Moussu  has  seen  numerous  cases  of  alimentary 
intoxication  in  lambs  whose  dams  were  fed  with  decomposed  beet  pulp, 
and  in  sucking  pigs  whose  mothers  had  received  bad  maize,  turnips,  etc. 

Diagnosis.  Careful  examination  of  the  substances  with  which  the 
animals  are  fed,  and  consideration  of  the  history,  prevent  confusion  with 
ordinary  poisoning.     Anthrax  as  a  cause  can  easily  be  eliminated. 

The  prognosis  is  grave,  unless  the  practitioner  is  summoned  early. 

The  lesions  are  those  of  acute  gastro-enteritis— congestion  of  the 
mucous  membrane,  abomasum,  and  intestine,  submucous  infiltration, 
shedding  of  the  epithelium,  which  sometimes  attains  the  stage  of  ulcera- 
tion, suffusion  and  intestinal  or  superficial  haemorrhage,  dilatation  of  the 
capillaries,  etc. 

The  symptoms  of  poisoning  are  produced  by  the  absorption  of  toxic 
products,  which  pass  from  the  intestine  into  the  blood  current. 

Poisoning  is  frequently  complicated  by  infection  produced  in  a  similar 
manner. 

Treatment.  The  first  point  is  to  change  the  food.  This  alone  is 
often  sufficient  to  disjDose  of  the  digestive  disturbance  in  a  week  or  tAvo. 
In  addition,  mustard  plasters  may  be  applied,  and  purgatives,  stimulants 
and  mucilaginous  drinks  may  l)e  given.  Finally,  diuretics  are  useful  in 
eliminating  the  toxic  products  accumulated  in  the  blood.  They  comprise 
general  stimulants  like  wine,  alcohol,  tea,  coffee,  etc.  Subcutaneous  or 
intravenous  injection  of  physiological  salt  solution  is  indicated. 

POISONING    BY    CAUSTIC    ALKALIES. 

The  cause  consists  in  the  administration  of  insufficiently  diluted 
solutions  of  ammonia  in  cases  of  tympanites,  or  the  ingestion  of  quick- 
lime, used  for  disinfecting  stables,  by  animals  suffering  from  depraved 
appetite. 

The  symptoms  indicate  injury  to  the  anterior  part  of  the  digestive 
tract.  They  consist  in  salivation,  loss  of  appetite,  colic,  indigestion, 
diarrhoea,  and  progressive  loss  of  strength. 

Diagnosis  is  only  jiossible  when  the  history  is  clear. 

The  prognosis  is  grave  if  the  doses  swallowed  have  been  so  large 
as  to  cause  severe  burning  of  the  mouth,  cesophagus,  rumen,  etc.  The 
local  lesions  are  grey  and  soft. 

Treatment  consists  in  immediately  giving  acidulated  draughts  con- 
taining vinegar  or  1,  2  or  3  per  cent,  of  hydrochloric  acid,  and  emollient. 


POISONING   BY   THE    NITRATES   OF   POTASH    AND   SODA.  217 

mucilaginous  drinks  containing  opium  for  the  purpose  of  calming  the 
irritation. 

POISONING    BY    CAUSTIC  ACIDS. 

Cases  of  this  kind  are  rare.  Gerlach  described  a  case  of  poisoning  by 
straw  which  had  been  removed  from  sulphuric  acid  carboys.  Abadie 
saw  a  number  of  cases  which  were  traced  to  the  unskilful  treatment  of 
two  empirics. 

The  symptoms  point  to  the  existence  of  stomatitis,  oesophagitis,  and 
gastro-enteritis.  Death  occurs  rapidly,  with  a  running-down  pulse.  On 
post-mortem  examination  one  discovers  more  or  less  deep  burning  of  the 
mucous  membrane  of  the  digestive  tract. 

The  diagnosis  is  difficult  in  the  absence  of  information. 

The  prognosis  is  grave. 

Treatment  comprises  administration  of  alkaline  draughts,  solutions 
of  bicarbonate  of  soda,  calcined  magnesia,  etc.,  and  of  mucilaginous  drinks 
containing  opium,  chalk,  etc.     This  may  produce  temporary  relief. 

Water  mixed  with  whipped  whites  of  eggs  is  also  extremely  valuable, 
but  it  is  often  better  to  slaughter  the  animal  as  soon  as  the  condition  is 
diagnosed. 

POISONING    BY    COMMON    SALT. 

This  form  of  poisoning  is  rare  in  oxen  on  account  of  the  large 
quantity  of  salt  which  can  be  ingested  without  producing  bad  effects. 
It  is  commonest  in  animals  to  which  old  brine  has  been  given  or  which 
have  received  rough  salt  containing  toxic  substances  (sheep  and  pigs). 
Beef,  pork,  or  fish  brine,  four  or  five  months  old,  is  especially  dangerous 
because  of  the  toxins  it  contains.  Half  a  pint  is  a  fatal  dose  for  a  pig 
(Reynal).  The  symptoms  include  marked  thirst,  vomiting  and  diarrhoea  ; 
at  a  later  stage  motor  and  nervous  disturbance  appears,  resulting  from 
poisoning  of  the  cerebro-spinal  system.  Paralysis,  epileptiform  convul- 
sions, trismus,  coma  and  death  characterise  extremely  acute  cases. 

To  the  naked  eye,  the  lesions  are  those  of  acute  gastro-enteritis  ; 
and,  in  many  cases,  of  marked  congestion  of  the  brain  and  medulla  and 
of  the  mucous  membrane  of  the  bladder. 

The  treatment  is  prophylactic  and  hygienic.  Old  brine  and  salt  of 
doubtful  purity  should  be  avoided.  The  symptoms  should  be  treated  by 
administering  diuretics,  preferably  soda  bicarbonate,  which  does  not 
irritate  the  kidney,  and  by  giving  mucilaginous  drinks  with  anodynes. 

POISONING    BY    THE    NITRATES    OF    POTASH    AND    SODA. 

This  form  of  poisoning  has  frequently  been  described  as  following  the 
ingestion  of  water  used  for  washing  sacks  which  have  contained  chemical 


218  POISONING. 

manures.  Occasionall,y  it  results  from  the  administration  of  medicines 
containing  excessive  doses  of  nitrate  of  potash.  The  symptoms  vary  in 
severity  with  the  purity  of  the  salt,  with  its  nature,  and  with  the  degree 
of  concentration  of  the  solution :  nitrate  of  potash  is  more  dangerous 
than  nitrate  of  soda. 

The  chief  symptoms  may  he  grouped  as  follows  : — 

Salivation,  indigestion  and  tympanites,  nausea,  vomiting,  diarrhoea, 
and  (especially)  intense  polyuria  :  the  kidney  may  he  irritated  to  such  a 
degree  as  to  produce  albuminuria  and  haematuria.  Intense  dulness 
and  general  weakness  precede  death,  which  sometimes  occurs  in  four  to 
twelve  hours  after  the  poison  has  been  taken. 

The  lesions  are  to  he  found  in  the  digestive  and  urinary  apparatus. 
The  kidneys  are  congested  and  hypertrophied,  or  present  changes  indi- 
cating epithelial  nephritis.  The  ureters  and  the  bladder  may  show 
similar  lesions. 

Treatment  comprises  removal  of  the  cause,  and  the  administration 
of  emollients,  narcotics,  and  diffusible  stimulants. 

POISONING    BY    TARTAR    EMETIC. 

Tartar  emetic  is  sometimes  given  for  the  purpose  of  favouring  secretion 
and  restoring  rumination  ;  occasionally  the  proper  dose  is  exceeded  and 
poisoning  occurs.  Given  repeatedly,  tartar  emetic  is  apt  to  accumulate 
in  the  deeper  portions  of  the  gastric  compartments  and  to  produce 
general  symptoms  of  super-purgation,  and  such  local  symptoms  as 
ulceration  and  even  perforation  of  the  walls  of  the  stomach,  which  in 
turn  is  followed  by  abscess  formation  in  the  abdominal  wall. 

Diagnosis  is  easy.     The  prognosis  is  grave. 

Treatment  is  confined  to  the  administration  of  mucilaginous  and 
diuretic  fluids.     Tannin  has  been  recommended. 

POISONING    BY    ARSENIC. 

Overdoses  of  Fowler's  solution  produce  rapidly  fatal  results,  in 
twenty-four  to  forty-eight  hours.     Lesions  are  little  marked. 

Arsenious  acid  acts  like  tartar  emetic  by  accumulating  and  producing 
local  gastritis  ;  it  may  also  cause  acute  poisoning,  being  in  that  case 
characterised  by  severe  colic  with  tympanites,  salivation,  and  foetid,  some- 
times blood-stained,  diarrhoea.  The  urine  becomes  albuminous,  and  re- 
mains scanty.  Incomplete  paralysis  is  sometimes  produced,  and  various 
forms  of  hgemorrhage  result  from  changes  in  the  constituents  of  the  blood. 

If  the  gastric  compartments  are  perforated,  an  abscess  may  develop 
in  the  abdominal  wall.  The  lesions  are  those  of  acute  gastro-enteritis. 
The  contents  of  the  stomach  exhales  an  odour  resembling  garlic.      The 


MERCURIAL   POISONING.  219 

parenchymatous  organs — the  Hver,  kidney,  and  heart — show  fatty  de- 
generation in  chronic  cases. 

In  prescribing  arsenic,  one  should  begin  with  small  doses,  which  can 
gradually  be  increased  as  the  animal  becomes  accustomed  to  the  drug. 
Curative  treatment  consists  in  administering  antidotes,  such  as  hydrated 
oxide  of  iron,  sulphate  of  iron,  and  calcined  magnesia. 

Haubner  described  a  form  of  chronic  arsenical  poisoning  produced 
in  the  neighbourhood  of  blast  furnaces  near  Freiberg.  Similar  forms 
of  poisoning  may  perhaps  occur  in  the  neighbourhood  of  chemical  and 
smelting  works  in  England. 

PHOSPHORUS    POISONING. 

Though  the  chronic  form  is  common  in  men,  phosphorus  poisoning 
only  occurs  accidentally  in  animals  through  eating  phosphorus  paste, 
used  as  a  poison  for  rats,  or  as  a  consequence  of  excessive  doses  given 
medicinally.     Some  cases  have  been  described  by  Maury. 

The  symptoms  comprise  salivation,  loss  of  appetite,  alliaceous 
odour  of  the  buccal  cavity,  arrest  of  intestinal  peristalsis,  indigestion, 
colic,  diarrhea,  exhaustion  and  death  in  a  state  of  coma.  Albumi- 
nuria and  icterus  also  occur. 

The  lesions  are  the  same  as  those  of  arsenical  poisoning — viz., 
stomatitis,  pharyngitis,  and  gastro-enteritis.  The  specific  changes  con- 
sist in  fatty  degeneration  of  the  liver  and  kidneys,  and  the  peculiar 
odour  resembling  garlic  exhaled  by  the  flesh. 

Death  is  a  consequence  of  deoxygenation  of  the  blood,  which  appears 
black,  and  when  spectroscopically  examined  reveals  only  the  lines  of 
reduced  hcTemoglobin. 

Treatment.  Oil  and  milk  dissolve  phosphorus  and  render  it  more 
easily  assimilable  ;  they  should  never  be  administered.  Large  doses  (up 
to  six  fluid  ounces)  of  essence  of  turpentine  have  been  recommended. 
This  prevents  the  phosphorus  absorbing  oxygen  at  the  expense  of  the 
blood.     Saline  purgatives  assist  in  eliminating  the  poison. 

MERCURIAL    POISONING. 

Mercurial  poisoning  may  result  either  from  the  administration  of 
medicines  or  from  accident.  Cases  of  the  former  kind  follow  the  internal 
use  of  sublimate  or  calomel.  Doses  of  2  to  2^  drams  of  calomel,  if 
repeated  for  a  certain  time,  may  prove  toxic  in  the  ox.  Accidental 
poisoning  results  from  the  use  of  mercurial  ointment  as  a  parasiticide 
over  large  surfaces.  Poisoning,  however,  rarely  occurs  unless  the  animal 
is  able  to  lick  the  parts.  Some  authors  have  tested  this  point  by  freely 
applying  mercurial  ointment  over  parts  likely  to  absorb  it  readily,  with- 
out having  seen  any  bad  effect. 


220  POISONING. 

Symptoms.  Free  salivation,  the  saliva  gradually  becoming  foetid 
and  blood-stained.  The  slight  irritation  of  the  buccal  membrane  first 
seen  is  soon  replaced  by  congestion  of  the  gums,  then  by  gingivitis  and 
periostitis,  with  local  ulceration  and  haemorrhage.  The  portion  of  the 
gums  surrounding  the  teeth  becomes  violet,  and  suppurative  alveolitis 
may  follow. 

As  a  consequence  of  disturbance  in  the  digestive  secretions  digestion 
ceases,  defaecation  becomes  irregular,  the  faeces  are  often  hard  and  coated, 
and  can  only  be  passed  with  difficulty,  though  sometimes  there  is  profuse 
foetid  diarrhoea. 

Eespiration  is  difficult,  jerky,  or  even  dyspnceic,  and  is  accompanied 
by  discharge  from  the  nose  and  by  expectoration.  The  gait  is  irregular, 
and  paral3'sis  may  follow.  Finally  the  skin  shows  an  eruption  resembling 
that  of  impetiginous  eczema ;  vesico -pustules,  covered  with  yellowish 
crusts,  appear  over  the  entire  surface  of  the  body. 

Lesions.  The  lesions  of  haemorrhagic  gastro-enteritis  are  sometimes 
accompanied  by  catarrhal  tracheo-bronchitis,  and  even  intra-pulmonary 
haemorrhage.  The  muscles  are  discoloured,  appear  as  though  boiled,  and 
are  covered  with  ecchymoses.  Blood  effusions  occur  beneath  the  ecze- 
matous  crusts,  but  the  rest  of  the  skin  is  anaemic. 

Treatment  includes  administration  of  raw  eggs,  or,  better  still,  of 
white  of  egg  beaten  up  in  water ;  the  albumen  in  coagulating  imprisons 
the  mercury.  Failing  these,  other  bodies,  like  flowers  of  sulphur  and 
iodide  of  potassium,  which  with  mercurial  salts  form  soluble  and 
harmless  compounds,  may  be  given.  Chlorate  of  potash  has  also  been 
recommended. 

Complications  like  stomatitis  and  gastro-enteritis  are  treated  b}^  the 
usual  methods. 

LEAD    POISONING  :    SATURNISM. 

Lead  poisoning  is  very  rare,  and  seldom  occurs  except  near  camps  or 
factories.  It  then  results  from  swallowing  lead  "  spray"  mixed  with  the 
grass  or  from  inhalation  of  lead  vapour. 

The  symptoms  comprise  salivation,  nausea,  colic,  obstinate  consti- 
pation, tympanites,  and  arrest  of  milk  secretion.  A  peculiar  form  of 
trembling  affects  the  head  ;  epileptiform  convulsions,  amaurosis,  and 
paralysis  may  also  occur.  General  sensibility  diminishes,  and  death 
follows. 

The  disease  may  assume  a  chronic  form,  characterised  by  a  blue  line 
around  the  gums,  changes  in  the  joints,  albuminuria,  and  bodily  wasting. 

The  lesions  are  those  of  ulcerative  stomatitis,  anaemia  of  the  mucous 
membranes,  and  fatty  degeneration  of  the  epithelium.  In  the  chronic 
form  the  kidneys  are  atrophied. 


POISONING   BY   ALOES.  221 

Treatment  consists  in  giving  substances  which  form  insokible  com- 
pounds Avith  lead.  It  comprises  the  administration  of  dikite  sulphuric 
acid,  solutions  of  sodium  sulphate  or  magnesia,  milk,  eggs,  and  iodide  of 
potassium. 

COPPER    POISONING. 

This  is  a  rare  form  of  poisoning.  It  may  follow  ingestion  of  food 
stored  in  copper  vessels,  licking  of  ointments  containing  copper  salts,  or 
ingestion  of  vine  leaves,  or  leaves  of  other  plants  which  have  been  sprayed 
with  sulphate  or  acetate  of  copper  to  prevent  "  mildew." 

The  symptoms  comprise  vomiting  of  green-coloured  material,  colic, 
diarrhoea,  muscular  weakness,  and  convulsions.  The  urine  contains  dis- 
solved albumen  and  haemoglobin. 

The  lesions  are  those  of  acute  enteritis  and  dilatation  of  the 
stomach.  The  essential  lesion  consists  in  decomposition  of  the  blood 
with  the  formation  of  methaemoglobin.  Nephritis  and  granular  degene- 
ration of  the  muscles  form  secondary  symptoms. 

Treatment  consists  in  administering  raw  eggs,  albumen,  milk,  muci- 
lage, flowers  of  sulphur,  or  calcined  magnesia. 

CARBOLIC    ACID    POISONING. 

Carbolic  acid  poisoning  sometimes  follows  the  use  of  carbolic  acid 
solutions  in  the  form  of  injections,  enemas,  or  baths. 

Symptoms.  Administered  in  over-doses  or  for  too  long  a  time,  car- 
bolic acid  produces  stomatitis,  oesophagitis  and  vomiting. 

True  poisoning  is  characterised  by  changes  in  the  kidneys  and  bladder  ; 
the  urine  becomes  Ijrown  and  turbid,  and  possesses  a  well-marked  carbolic 
odour,  the  animals  suffer  from  severe  trembling  and  appear  stupid,  and 
coma  and  paralysis  precede  death. 

The  specific  lesions  consist  in  parenchymatous  nephritis,  sometimes 
accompanied  by  renal  haemorrhage,  cystitis  and  hyperemia  of  the  lung 
and  brain.  The  flesh  has  an  odour  of  carbolic  acid,  which  renders  it  unfit 
for  human  consumption. 

Treatment  consists  in  giving  stimulants  and  slight  diuretics,  such 
as  ether,  alcohol,  wine,  coffee,  saline  sulphates,  or  Glauber's  salt.  The 
last  named  forms  phenyl-sulphuric  acid,  which  is  not  toxic.  Olive, 
rape,  or  linseed  oil  has  been  recommended.  All  these  drugs  are  useless 
if  the  kidney  lesions  have  become  too  pronounced. 

POISONING    BY    ALOES. 

This  form  of  poisoning  is  caused  by  administering  over-doses  of  aloes. 

Apart  from  the  accidents  possible  in  pregnant  female  animals,  large 
doses  of  aloes  produce  symptoms  of  super-purgation — profuse  diarrhoea, 
running  down  pulse,  and  nervous  prostration. 


222  POISONING. 

The  lesions  are  those  of  gastro-eiiteritis,  the  intestine  l)eing  empty, 
and  its  mucous  membrane  of  red  colour. 

Treatment  is  confined  to  administering  drugs  Hke  camphor,  rice, 
bismuth,  opium,  chloral,  and  emollients,  which  diminish  peristalsis  and 
lessen  secretion. 

IODOFORM    POISONING. 

The  causes  are  limited  to  the  licking  of  wounds  which  have  been 
dressed  with  iodoform. 

The  symptoms  include  gastric  disturbance,  somnolence,  coma,  and 
the  signs  of  iodism. 

The  only  lesions  are  those  of  fatty  degeneration  of  the  kidneys  and 
liver. 

Treatment  comprises  the  exhibition  of  vomitants,  stimulants,  and 
diuretics. 

IODINE    POISONING  :    IODISM. 

Death  by  iodine  poisoning  is  absolutely  exceptional :  the  complications 
described  under  the  name  of  iodism  are  rather  to  be  referred  to  satura- 
tion of  the  organism  than  to  true  poisoning. 

The  cause  of  iodism  is  unduly  prolonged  administration  of  iodide  of 
potassium,  or  of  iodine  in  solution. 

The  symptoms  include  discharge  from  the  eyes,  coryza,  hypersecre- 
tion from  all  the  mucous  membranes,  and  gastric  disturbance.  The 
cutaneous  eruption  exhibits  special  peculiarities,  including  desquamation 
of  the  epidermis  in  the  form  of  bran-like  scales,  and  pruritus. 

The  first  indications  in  treatment  are  to  discontinue  the  drug  and  to 
administer  stimulants  and  nutrients  like  milk,  cod-liver  oil,  etc. 

STRYCHNINE    POISONING. 

Strychnine  poisoning  is  most  commonly  due  to  over-doses  of  the  drug 
accidentally  given  during  treatment. 

The  symptoms  comprise  tetanic  convulsions,  hyperaesthesia  and 
dyspnoea.  As  a  result  of  muscular  rigidity,  the  ribs  cannot  be  moved, 
and  death  by  asphyxia  follows. 

Treatment  comprises  the  use  of  anaesthetics,  and  the  administration 
of  chloral  hydrate,  as  long  as  the  contractions  continue.  Bromide  of 
potassium,  tobacco,  tannin,  etc.,  are  also  useful. 


The  chief  part  of  the  botanical  descriptions  in  the  following  list  have 
been  extracted,  by  permission,  from  the  Annual  Eeport  for  1898  of  the 
United  States  Bureau  of  Animal  Industry,  p.  392.    To  Dr.  D.  E.  Salmon, 


PLANTS   POISONOUS   TO   STOCK.  223 

who  gave  this  permission,  and  who  also  kindly  supplied  the  blocks,  the 
writer  (Mr.  Dollar)  desires  to  express  his  very  sincere  thanks.  Consider- 
able modifications  have  been  made,  and  in  the  case  of  the  more  important 
poisonous  plants,  details  of  symptoms  and  treatment  have  been  added. 

LIST    OF    PLANTS    POISONOUS    TO    STOCK.* 

perisporace.t;  (rot-moitld  family). 

Aspergillus  glaucus. — This  is  the  common  flocculent  woolly  mould 
which  sometimes  develops  to  a  dangerous  extent  on  corn,  oats,  and  other 
food  grains  which  have  either  been  harvested  before  full  maturity  or  been 
stored  in  a  damp  place.  The  mouldy  growth  is  pure  white  at  first,  but 
changes  with  the  ripening  of  the  spores  to  gray  and  then  green.  The 
spores  are  apparently  the  cause  of  the  so-called  enzootic  cerebritis,  or 
"  staggers,"  of  horses,  which,  during  the  winter  of  1898-99,  was  rej^orted 
as  having  caused  very  heavy  losses  in  the  southern  portion  of  the  United 
States.  European  investigators  have  shown  that  the  spores  of  this  mould 
will  grow  within  the  living  body  if  they  are  introduced  into  the  blood. 
Death  is  probably  caused  by  some  poison  which  is  simultaneously  produced 
with  the  mould  in  the  body  of  the  animal. 

HYPOCREACE.E    (eRGOT    FAMILY). 

*ClaYiceps  purpurea. — This,  the  most  common  species  of  ergot, 
infests  various  species  of  native  and  cultivated  grasses.  It  sometimes 
causes  great  losses  of  stock. 

POISONING    BY    ERGOT    OF    RYE  :    ERGOTISM. 

Causation.  This  form  of  poisoning  is  due  to  the  presence  of  ergot  in 
grain  or  forage. 

Symptoms.  The  symptoms  are  seldom  very  marked.  In  mild  cases 
pregnant  females  may  abort ;  grave  cases  are  indicated  by  local  gangrene 
of  the  mucous  membrane  and  gangrene  of  the  extremities,  particularly 
in  poultry,  in  consequence  of  the  constrictive  action  of  the  drug  on  the 
peripheral  blood-vessels,  on  the  vaso-motor  centres,  and  on  unstriated 
muscular  fibres. 

Treatment.  The  use  of  chloral  and  morphine  has  been  suggested  in 
this  condition ;  but  as  the  lesions  when  discovered  are  established  and 
permanent,  this  treatment  seems  illusoiy.  More  is  to  be  expected  from 
preventive  measures  and  the  avoidance  of  ergotised  food. 

*  The  names  of  plants  proved  beyond  doubt  to  be  poisonous  to  stock  are  marked 
with  an  asterisk.  The  evidence  in  regard  to  the  toxic  properties  of  others  is  not  in 
every  case  entirely  convmcmg,  though  there  is  good  ground  for  strong  suspicion. 


224 


POISONING. 


USTILAGINACE.E    (SMUT    FAMILY). 

Ustilago  maydis. — The  black  powdery  fungus  known  as  corn  smut  is 
common  throughout  the  corn-producing  districts  of  the  central  United 
States,  and  is  occasionally  reported  as  being  fatal  to  stock.  Experiments 
made  in  Wisconsin  and  elsewhere  show  that  it  is  not  a  very  active  poison 
when  eaten  in  moderate  quantity.  When  given  in  gradually  increasing 
amounts  up  to  2  lbs.,  no  effect  was  noted,  but  4  lbs.  on  each  of  two 
successive  days  caused  the  sudden  death  of  one  cow.     Since  corn  smut 


Fig.  74. — Fly  anianita  {Annuiita  Duiscaria).     a,  Mature  plant;  h,  top  view  of  cap 
showing  corky,  patches — both  one-lialf  natural  size. 

has  l)een  shown  to  be  less  fatal  when  wet,  it  seems  probable  that  its 
physical  and  not  its  chemical  character  may  be  responsible  for  the  death 
of  cattle  which  have  eaten  it  in  considerable  quantity. 


POISONING    BY    SMUT    OF    BARLEY. 

Causes.     The  presence  of   smut  in  straw,  in  millers'  grains,  or  in 
damaged  kiln-dried  grains  which  have  fraudulently  been  added  to  grain 


PLANTS   POISONOUS   TO   STOCK.  •  225 

sold  for  feeding,  represents  the  principal  source  of  this  form  of 
poisoning. 

The  symptoms  are  very  vague.  There  is  indigestion,  with  a  ten- 
dency to  nausea,  and  vomiting.  Diarrhoea  may  be  present :  At  a  later 
stage  the  heart  and  nervous  system  are  affected.  The  gait  becomes  hesi- 
tating, the  animals  show  general  dulness  and  spasm  of  the  pharynx ; 
death,  when  occurring,  is  by  cardiac  or  respiratory  syncope. 

Treatment  consists  in  giving  an  entire  change  of  food,  and  adminis- 
tering stimulants  and  purgatives. 

AGARICACEiE    (MUSHROOM    FAMILY). 

Amanita  muscaria. — The  well-known  fly  amanita  (fly  fungus  ;  deadly 
amanita)  may  be  found  from  spring  to  early  winter  in  pine  forests 
throughout  the  United  States.  Cows  are  supposed  to  be  killed  by  eating 
it,  and  almost  every  year  the  daily  papers  chronicle  the  death  of  several 
human  beings  who  were  led  to  eat  the  fungus  through  mistake  for  some 
edible  species.  The  fresh  cap  is  frequently  rubbed  up  with  milk  and 
used  to  poison  flies. 

PHALLACE^    (STINK-HORN    FAMILY). 

*Clathrus  columnatus. — In  an  article  published  in  the  Botanical 
Gazette  (Vol.  XV.  p.  45),  Dr.  Farlow,  of  Harvard  University,  gives  an 
account  of  an  investigation  of  a  case  of  poisoning  in  hogs  which  was 
caused  by  eating  this  peculiar  fungus.  It  grows  in  patches  in  oak  woods 
and  openings,  and  is  quite  common  throughout  the  Southern  States. 

POLYPODIACE^    (fern    FAMILY). 

Pteris  aquilina. — In  July,  1895,  nineteen  cattle  died  in  Maryland, 
which  were  supposed  to  have  been  poisoned  by  eating  the  common 
bracken  fern.  Very  few  similar  cases  are  on  record,  but  one  European 
authority  cites  one  in  which  five  horses  were  killed  by  eating  hay  con- 
taminated with  this  fern,  and  another  states  that  cases  are  quite  frequent 
among  cattle  in  England. 

EQUISETACE^    (hORSETAIL    FAMILY). 

Equisetum  arvense. — The  field  horsetail  was  reported  from  Con- 
necticut in  1871  as  being  poisonous  to  horses.  Cases  are  very  rare,  and 
it  is  probable  that  this  plant  is  deleterious  only  when  eaten  in  consider- 
able quantity,  and  then  perhajjs  only  on  account  of  its  physical  character. 
Experiments  made  in  Europe  show  that  a  similar  species  {E.  j^alustrc)  is 
fatal  to  horses  when  fed  in  considerable  quantity  with  hay. 

D.C.  Q 


226  •  POISONING. 

TAXACE.E    (yEAV    FAMILY). 

Taxus  minor. — The  common  yew,  or  ground  hemlock,  is  called  poison 
hemlock  in  some  places.  The  leaves  of  this  shrub  are  probably  poisonous 
to  stock,  as  are  those  of  the  European  yew.  This  species  is  more  acces- 
sible to  stock  than  the  western  yew  {Taxus  hrevifolia) ,  which  grows  only 
in  deep  caiions. 


YEW    POISONING    (TAXUS    BACCATA). 

The  leaves  of  yew,  when  eaten  in  any  considerable  quantity,  are  very 
poisonous.  Two  ounces  to  eight  ounces,  according  to  the  size  of  the 
animal,  slow  the  heart's  action,  produce  weakness,  staggering,  and 
apoplectic  congestion,  which  may  have  a  fatal  result  in  less  than  an 
hour.  The  bark  is  less  injurious,  and  the  fruit  is  scarcely  poisonous 
at  all. 

The  early  symptoms,  which  are  only  seen  in  chronic  cases,  consist 
in  excitement,  followed  by  somnolence  and  muscular  weakness,  with 
slowing  of  the  respiration  and  circulation. 

POACE^    (grass    family). 

Lolium  temulentum. — The  seed  of  the  darnel,  or  poison  rye  grass,  an 
introduced  annual  especially  abundant  on  the  Pacific  Slope,  is  considered 
poisonous  to  both  man  and  animals. 

Stipa  robusta. — This  is  a  perennial  plant  which  is  known  in  x\rizona 
and  New  Mexico  as  sleepy  grass.  It  produces  a  narcotic  effect  on  horses 
and  cattle  that  feed  upon  it,  but  stock  bred  in  that  region  rarely  touch  it. 

Zea  mays. — -The  numerous  deaths  that  are  frequently  attributed  to 
Indian  corn  are  mostly  due,  not  to  any  poison  inherent  in  the  plant,  but 
rather  to  parasitic  or  saprophytic  fungus  growths,  as  noted  under  Asper- 
gillus  and  Ustilago.  The  green  fodder  is  very  apt  to  cause  severe  and  even 
fatal  tympanites  if  the  animal's  diet  is  not  properly  regulated.  Death 
has  also  been  attributed  to  the  presence  of  nitre  (potassium  nitrate)  in 
the  growing  stalks.  It  is  supposed  that  in  very  rich  soil  this  substance 
will  sometimes  accumulate  in  the  stalks  in  considerable  quantity  during 
prolonged  drought. 

poisoning  by  the  biale  tufts  of  maize. 

The  green  tufts  alone  are  toxic  ;  the  toxicity  disappears  after  drying. 
Prolonged  administration  produces  nephritic  colic  and  renal  lithiasis. 

poisoning  by  sweet  sorghum  grass. 

This  form  of  poisoning  is  characterised  by  attacks  of  trembling, 
tympanites,  and  frequent  attempts  to  urinate.     The  heart  beats  feehly. 


PLANTS   POISONOUS   TO   STOCK. 


227 


and  the  jiulse   grows   progressively   weaker,    until   at   last   it  becomes 
imperceptible. 

MELANTHACE.E    (bUNCH-FLOWER    FAMILY)- 

*Chrosperma  muscsetoxicum. — The  bulbous  portion  of  the  fly  poison, 
or  crow  poison,  an  eastern  plant,  is  sometimes  eaten  by  cattle  with  fatal 


Fig.  75. — False  hellebore  [Veratrum 
viride),  one-third  natural  size. 


Fig.  76.— Lily  of  the  valley  {Con- 
vallaria  majdlis),  one-third 
natural  size. 


results.  The  bulbs,  when  crushed  with  molasses,  are  used  to  stupefy 
flies. 

*Yeratrum  viride. — The  leaves  of  the  common  swamp  hellebore 
(American  white  hellebore ;  false  hellebore  ;  Indian  poke)  of  the  eastern 
and  northern  portions  of  the  United  States  have  proved  fatal  to  man  and 
to  horses.  Sheep  eat  the  young  leaves  and  shoots  with  apparent  relish. 
The  seed  is  poisonous  to  chickens. 

Zygadenus  venenosus. — The  name  death  camas  has  been  applied 
to  this  plant  in  the  North-West  of  America  to  distinguish  it  from  the 
true  camas  {Quamasia  qnamash),  which  is  highlv  esteemed  for  food  by 

Q  2 


228  POISONING. 

the  Indians.  In  Oref:>on  it  is  erroneously  called  "lobelia"  by  most 
stockmen  and  farmers.  Horses,  cattle,  and  sheep,  as  well  as  man, 
are  poisoned  by  eating  the  bulb. 

Zygadenus  elegans. — The  bulbs,  and  perhaps  the  leaves,  of  the 
GlaiuoK.s  zi/iiddciiiiii,   or    alkali  grass,   are  poisonous  to  cattle. 

COXVALLARIACE.E    (lILY    OF    THE    VALLEY    FAMILY). 

Convallaria  majalis. — All  parts  of  the  lily  of  the  valley  are  power- 
fully poisonous,  and  are  liable  to  injure  cattle  and  horses. 

H.KMODOIIACE.E    (BLOODWORT    FAMILY). 

Gyrotheca  capitata. — This  is  the  red  root,  or  paint  root,  of  the 
Atlantic  coast  and  Cuba,  so  called  on  account  of  the  red  colour  of  its 
sap.  White  hogs  are  supposed,  throughout  the  Southern  United  States, 
to  be  particularly  sul)ject  to  the  poison  contained  in  the  plant. 

faCtACe.e  (beech  family).  " 

Quercus  sp. — In  Europe  the  acorns  of  various  species  of  oak  cause 
sickness  and  death  in  hogs  and  cattle.  This  efi'ect  may  possibly  be  due 
to  tympanites,  but  may  also  be  due  in  some  w'ay  to  the  tannin  or  the 
bitter  principle  which  they  contain. 

poisoning  by  acorns. 

The  acorn,  or  fruit  of  the  oak  {Qaercus  rohiir  and  Quercus  sessili- 
Jiora),  is  much  valued  as  a  food  for  swine.  "A  peck  of  acorns  a  day 
with  a  little  bran  will  make  a  hog,  'tis  said,  increase  a  pound  w'eight 
jwr  diem  for  two  months  together."  Though  largely  consumed  by  swine 
with  no  apparent  ill  eftects,  acorns  constitute  a  dangerous  food  for  young 
cattle,  especially  when  eaten  before  they  are  ripe  and  when  herbage  or 
other  feeding  is  scanty  or  restricted. 

The  symptoms  comprise  dulness,  loss  of  appetite,  constipation, 
followed  by  diarrhtea,  with  straining  and  colick}'  pains,  head  carried 
low,  eyes  retracted,  with  mucus  about  the  eyelids  and  blood-stained 
discharge  from  the  nose.  Frequently  the  abdomen  is  distended. 
Temperature  normal. 

The  lesions  are,  abrasions  of  the  buccal  membrane  on  the  palate, 
cheeks,  etc. ;  impaction  and  intense  congestion  of  the  omasum. 

Treatment.  Change  of  pasture.  Alkalies — potash  or  soda  bicar 
bonate,  magnesia ;  tonics  and  stinudants. 


PLANTS   POISONOUS   TO   STOCK. 


229 


URTICACE.E    (nettle    FAMILY), 

*  Urtica  gracilis. — The  slender  nettle  covers  thousands  of  acres  of 
reclaimed  swamp  land  in  ]\Iicliigaii  and  Wisconsin,  which  is  made  nearly 
worthless  by  its  dense  growth,  horses  refusing  to  pass  through  it  to  culti- 
vate the  soil. 

CHEXOPODIACE.E    (gOOSEFOOT    FAMILY). 


Sarcobatus  vermiculatus. — Black 
shrub  which  grows  iii  strongly 
alkaline  soil  in  the  south-western 
and  western  portions  of  the  United 
States.  A  correspondent  in  New 
Mexico  states  that  on  one  occasion 
he  counted  as  many  as  1,000  sheep 
that  had  been  killed  by  eating,  the 
leaves  of  this  plant.  It  is  claimed 
that  cows  are  not  affected  by  eating 
it  at  any  time,  and  that  sheep  can 
Qat  it  quite  freely  in  winter.  Death 
is  perhaps  due  more  to  tympanites 
rather  than  to  any  poisonous  sub- 
stance which  the  plant  contains. 

PHYTOLACCACE.E   (POKEWEED  FAMILY). 

*  Phytolacca   decandra.  —  The 

leaves  of  the  common  pokeweed 
(poke ;  garget ;  American  night- 
shade) of  the  eastern  half  of  the 
United  States  is  occasionally  eaten 
by  cattle  with  fatal  results. 


greasewood,  or  cliico,  is  a  scraggy 


Fig. 


-Sleiuler  nettle  {Urtica  gi-aciJis). 


ALSINACE.E    (pink    FAMILY). 

*  Agrostemma    githago.  —  The 
common  corn  cockle  (cockle;  mul- 
lein pink)   is  a  weed  common  to  both  the  United  States  and  Europe. 
Poultry  and  household  animals  are  occasionally  poisoned  by  eating  the 
seeds  or  the  bread  made  from  wheat  contaminated  with  the  seeds. 


MAGNOLIACE.F.    (MAGNOLIA    FAMILY). 

lUicium  floridanum. — The   leaves  of   this   species   of  anisetree  are 
supposed  to  be  poisonous  to  stock. 


230 


POISONING. 


EANUNCULACE.E    (CROWFOOT    FAMILY). 

*  Aconitum  napellus. — Aconite  (monkshood ;  wolfsbane)  is  very  com- 
monly cultivated  in  gai'dens,  and  is  therefore  capable  of  doing  great 
damage  to  stock.  Horses  and  cattle  have  frequently  been  poisoned  by 
eating  the  leaves  and  flowering  tops. 

*  Aconitum  columbianum. — The  Western  aconite,  or  monkshood,  is 
native  in  the  north-western  portion  of  America,  where  it  sometimes 
poisons  sheep. 

Anemone  quinquefolia. — The  common  wind  flower,  which  grows 
throughout  most  of  the  United  States,  is  extremely  acrid  and  poisonous. 
Cattle  seldom  touch  it.     The  plant  loses  most  of  its  poison  in  drying. 


Fig.  78. — Pokeweed  {Phytolacca  clecandra),  one-half  natural  size. 


*  Delphinium  tricorne. — The  dwarf  larkspur,  or  stagger  weed,  of  the 
north-eastern  quarter  of  the  United  States  has  been  especially  reported 
from  Oliio  as  fatal  to  cattle  in  April,  when  the  fresh  leaves  appear. 

*  Delphinium  consolida. — The  seeds  of  the  commonly  introduced 
field  larkspur  are  well  known  to  be  poisonous;  the  leaves  are  known 
in  Europe  to  be  fatal  to  cattle. 

*  Delphinium  menziesii.--The  purple  larkspur  of  the  north-western 
quarter  of  the  United  States  is  very  common  throughout  Montana.  In 
one  case  of  poisoning  reported  by  Dr.  E.  V.  Wilcox,  of  the  Montana 
Experiment  Station,  over  GOO  sheep  were  affected,  250  of  which  were 
claimed  to  have  been  killed   by  the  weed.      An  experiment  made  by 


PLANTS   POISONOUS   TO   STOCK. 


231 


Dr.  S.  B.  Nelson,  Professor  of  Veterinary  Sciences  in  the  Washington 
State  Agricultural  College,  shows  that  it  is  possible  to  feed  as  much  as 
24f  lbs.  of  the  fresh  leaves  to  a  sheep  within  a  period  of  five  days 
without  any  apparent  ill  effect  taking  place.  An  experiment  made  by 
Dr.  Wilcox  shows  that  the  extract  from  less  than  an  ounce  of  the  dried 


Ftg.  79. — Corn  cockle  {Agrostemma  git- 
liago).  a,  Sprays  showing  flowers  and 
seed  capsule,  one-third  natural  size ; 
6,  seed,  natural  size ;  h,  seed,  four 
times  natural  size. 


Fig.  80. — Aconite  {Aconitum  columhia- 
man),  a,  Flowering  plant ;  b,  seed  cap- 
sule— both  one-third  natural  size. 


leaves  killed  a  yearling  lamlj  in  two  hours,  the  dose  having  Ijeen  given  by 
way  of  the  mouth. 

LARKSPUR    POISONING    IN    SHEEP.* 

Severe  losses  have  from  time  to  time  been  recorded,  especially  in 
America,  from  larkspur  poisoning,  the  number  of  animals  lost  amounting 

*  The  following  account  is  summarised  from  a  bulletin  of  the  Montana  Experiment 
Station  by  Dr.  WUcox. 


232  POISONING. 

to  tliousands.  The  first  signs  of  poisoning  are  slight  general  stiffness 
and  straddling  gait,  esi)ecially  of  the  hind  legs.  The  stiffness  hecomes 
more  and  more  pronomiced,  until  walking  is  difficult  and  evidently  painful. 
Soon  there  are  manifested  various  involuntary  twitchings  of  the  muscles 
of  the  legs  and  sides  of  the  body,  and  loss  of  control  or  co-ordination  of 
the  muscles.  Ordinarily  there  is  no  increase  in  the  quantity  of  the  saliva, 
no  dribbling  of  saliva  from  the  mouth,  no  champing  of  the  jaws  or  at- 
tempts at  swallowing.  The  sheep  manifest  none  of  the  mental  disturb- 
ances frequently  seen  in  cases  of  poisoning  from  other  sources,  as  for 
example  loco-weed  and  lupine.  There  is  no  impairment  of  the  special 
senses.  The  sheep  seem  to  hear  and  see  as  well  and  as  correctly  as  under 
normal  conditions  of  health. 

Xo  indications  of  any  disturbances  of  the  digestive  functions  are  to  be 
seen.  The  appetite  remains  good,  and  the  sheep  eat  up  to  the  ver}^  last. 
They  were  observed  eating  industriously  during  the  intervals  between  the 
attacks  of  spasms  which  they  have  during  the  last  stages. 

At  first  the  frequency  of  the  pulse  and  of  the  respiratory  movements 
is  lessened  and  the  temperature  is  lowered.  The  pulse  remains  very 
weak,  but  in  the  later  stages  becomes  very  rapid,  in  some  cases  180  per 
minute.  Toward  the  last  also  the  respiration  is  very  shallow  and  rapid. 
During  the  final  convulsions  the  respiration  is  sometimes  120  per  minute, 
but  so  shallow  that  the  air  is  simply  pumped  up  and  down  the  windpipe. 
The  air  in  the  lungs  is  therefore  not  renewed,  and  the  animal  dies  by 
asphyxia  or  suffocation. 

So  long  as  the  sheej)  can  stand  on  its  feet,  or  walk,  it  keeps  up  with 
the  flock  as  nearly  as  possible.  The  exercise,  however,  excites  it,  makes 
its  respiration  more  rapid,  and  it  has  frequently  to  lie  down  for  a  moment 
and  then  get  up  and  hobble  along  after  the  flock.  The  worst  cases  can 
thus  easily  be  detected,  since  they  straggle  behind'the  rest  of  the  flock. 

The  later  stages  follow  rather  rapidly.  The  involuntary  movements 
become  more  frequent  and  more  severe.  All  four  legs  tremble  and  shake 
violently.  In  fact,  all  the  muscles  of  the  body  contract  si)asmodically  until 
the  animal  totters  over  on  its  side  and  dies  in  the  most  violent  spasms. 

LarksjDur  has  the  effect  of  arresting  the  heart's  action  and  respiration 
and  of  paralysing  the  spinal  cord. 

Treatment.  Place  the  animal  by  itself  in  a  cool,  quiet,  shaded  place 
and  avoid  all  excitement.  Of  the  drugs  tested,  atropine  sulphate  dis- 
solved in  camphor  water  has  given  the  best  results.  Wilcox  (Bull.  15, 
Montana  Ex.  Station)  recommends  for  sheep  from  ^\^  to  ^^  grain  in  the 
earlier,  and  ^  to  -|  grain  in  the  later  convulsive  stages.  Cattle  require 
from  four  to  five  times  these  doses.  Inhalations  of  ammonia  vapour, 
and  small  doses  of  alcohol  and  ether,  are  also  useful. 

In  other  cases  very  good   results  have  been  obtained  from  giving 


Fi(i.  81. — DeJphininni  )nenziesii. 

(To  illustrate  "  Larkspur  Poisoning."     From  the  Annual  Report,  U.S.A. 

Department  of  Agriculture,  1898.) 


Fig.  82. — Delnhinium  menzicsii. 

(To  illustrate  "  Larkspur  Poisoning."     From  the  Annual  Report,  U.S.A. 

Department  of  Agriculture,  1898.) 


Fig.  83. — Ddplnnium  scopulonim. 
(To  illustrate  "  Larkspur  Poisoning."     From  the  Annual  Report,  U.S.A. 
Department  of  Agriculture,  1898.) 


PLANTS   POISONOUS   TO   STOCK. 


233 


permanganate  of  potash  in  the  form  of  a  drench  :  5  to  10  grains  for  an 
adult  sheep  or  pig,  15  to  20  grains  for  a  horse,  and  30  to  50  grains  for  an 
ox,  dissolved  in  a  pint  or  two  pints  of  water. 

*  Delphinium  geyeri. — TheAVyoming  larlispur  is  well  known  through- 
out Wyoming,  Colorado,  and  Nebraska  under  the  name  of  poison  weed. 


Fig.  84. — Dwarf  larkspur  {Del])liiniuvi 
tricorne),  one-third  natural  size. 


Fig.  8.5. — Cursed  crowfoot  (Bannnciihis 
sccleratus.) 


It  is  reported  to  be  the  most  troublesome  plant  to  stock  in  Wyoming,  the 
dark-green  tufts  of  foliage  being  especially  tempting  in  spring  when  the 
prairies  are  otherwise  dry  and  barren. 

Delphinium  recurvatum. — This  species  of  larkspur  grows  in  wet  sub- 
saline  soil  in  the  southern  half  of  California.  It  has  been  reported  from 
San  Luis  Obispo  county  as  fatal  to  animals. 

Delphinium  scopulorum. — The  tall  mountain  larkspur  of  the  Rocky 
Mountains  has  been  reported  to  the  Canadian  Department  of  iVgriculture 
as  poisonous  to  cattle  in  the  high  western  prairies  of  Canada. 

Delphinium  trolliifolium. — This  plant  is  common  throughout  the 
coast    region    of    northern    Cahfornia,    Oregon,    and   Washington.      In 


234 


POISONING. 


Humboldt  Count}',  Cal.,  it  is  known  as  cow  poison,  on  account  of  its 
fatal  effect  on  cattle.  Its  toxic  character  has  been  questioned.  Per- 
haps it  is  not  e(|ually  poisonous  throughout  all  stages  of  its  growth. 

*Helleborus  viridis. — -The  green  hellebore  is  a  European  plant,  some- 
times self-sown  from  gardens.  All  parts  of  the  plant  are  poisonous. 
Cattle  have  been  killed  by  eating  the  leaves. 


POISONING    BY    HELLEBORE. 

This   form  of  poisoning  is  of  slow  progress,   the   plant   producing 

irritation  of  the  digestive  mucous 
membrane.  The  symptoms  con- 
sist in  loss  of  appetite,  blackish, 
glairy  diarrhoea,  and  intermittence 
of  the  pulse. 

*  Ranunculus     sceleratus  .  — 

The  cursed  crowfoot,  or  celery- 
leafed  crowfoot,  is  found  through- 
out the  eastern  half  of  the  United 
States  and  also  in  Europe.  Cattle 
generally  avoid  all  of  the  butter- 
cups, but  fatal  cases  of  poisoning 
from  this  plant  are  recorded  in 
European  literature.  When  dried 
in  hay,  the  plant  appears  to  be 
non-poisonous.  The  bulbous  crow- 
foot (R.  hidbosas)  and  the  tall  crow- 
foot {R.  acris)  are  well-known  to 
be  very  acrid  in  taste,  and  it  is 
probable  that  all  of  the  species 
which  grow  in  water  or  in  very 
marshy  land  are  poisonous. 

POISONING    BY    RANUNCULACE.E. 
l^iG.  bb. — Mandrake  {rodo'jikijUum 

pelt  a  turn).  Poisoning    only   occurs    when 

the  green  plants  are  eaten.  Dry- 
ing causes  certain  essences  contained  in  them  to  disappear,  and  thus 
destroys  their  toxicity. 

This  form  of  poisoning  is  indicated  by  yawning,  colic,  blackish,  fcetid 
diarrhoea,  and  rapid  loss  of  strength. 

The  animals  suffer  from  stertorous  breathing,  weakness  of  the  pulse, 
and  aberration  of  vision.     They  die  in  convulsions. 


PLANTS   POISONOUS   TO   STOCK.  235 

BERBERIDACE.^    (BARBERRY    FAMILY). 

Podophyllum  peltatum. — The  leaves  of  the  common  mandrake,  or 
May  apple,  of  the  eastern  half  of  the  United  States,  are  sparmgly  eaten 
by  some  cattle.  Cases  of  poisonmg  are  very  rare,  but  the  experience 
of  one  correspondent  shows  that  the  milk  from  a  cow  that  had  been 
feeding  on  the  plant  off  and  on  for  about  three  weeks  was  so  extremely 
laxative  as  to  be  positively  poisonous.  The  accident  occurred  to  a  baby, 
fed  exclusively  on  cow's  milk.  The  physiological  effect  of  the  milk  was 
precisely  like  that  of  mandrake.  It  was  shown  that  the  cow  ate  the  plant, 
which  was  abundant  in  one  pasture,  and  when  the  animal  was  removed 
to  a  pasture  free  from  the  plant  the  child's  illness  stopped  at  once. 

BUTNERIACE^    (STRAWBERRY- SHRUB    FAMILY). 

Butneria  fertilis. — The  large  oily  seeds  of  the  calycanthus,  or  sweet- 
scented  shrub,  contain  a  poisonous  alkaloid,  and  are  strongly  reputed  to 
be  poisonous  to  cattle  in  Tennessee. 

PAPAVERACEiE    (POPPY    FAMILY). 

Argemone  mexicana. — The  Mexican  poppy  is  reputed  to  be  poisonous 
to  stock  both  in  the  United  States  and  in  New  South  Wales.  The  seeds 
are  narcotic,  like  opium. 

*  Chelidonium  majus. — The  yellow  milky  sap  of  the  celandine,  an 
introduced  weed  common  in  the  eastern  United  States,  contains  both  an 
acrid  and  a  narcotic  poison.  Both  are  powerfully  active,  but  cases  of 
poisoning  are  rare,  as  stock  refuse  to  touch  the  plant.  Eeeks,  of  Spalding, 
however,  describes  (J.  Comp.  Path,  and  Tlicrap.,  Dec.  1903,  p.  367)  an 
outbreak  of  poisoning  by  common  celandine  in  which  twenty-one  valu- 
able cows  were  affected  and  three  died.  The  symptoms  comprised  exces- 
sive salivation  and  thirst,  convulsions,  unconsciousness  and  epileptiform 
movements. 

*  Papaver  somniferum,  opium  poppy,  or  garden  poppy  :  P.  rhoeas, 
field  poppy,  red  poppy,  or  corn  poppy. — These  plants  are  sometimes 
self-sown  from  gardens.  Both  contain  acrid  and  narcotic  poisons,  and 
European  literature  records  the  death  of  various  animals  from  eating 
their  leaves  and  seed  pods. 

POISONING    BY   POPPIES. 

The  consumption  of  poppies  causes  arrest  of  peristalsis,  secretion  of 
foamy  saliva,  colic,  depression,  coma,  and  in  severe  cases  death  by 
stoppage  of  respiration. 


236 


POISONING. 


PRUNACE.E    (plum    FAMILY). 

*  Prunus  caroliniana. — The  laurel  cherry,  or  mock  orange,  is  native 
in  the  south-eastern  quarter  of  the  United  States,  and  is  there  often 
cultivated  for  hedges.  The  half-withered  leaves  and  the  seeds  yield 
prussic  acid,  and  .are  poisonous  when  eaten  hy  animals. 

*  Prunus  serotina. — The  wild  black  cherry  is  a  valuable  forest  tree 
which  ranges  througliout  the  eastern  half  of  the  United  States.     Cattle 

are  killed  by  eating  the  partially 
withered  leaves  from  branches 
thrown  carelessly  within  their 
reach  or  ignorantly  offered  as 
food.  The  leaves  of  various  other 
wild  and  cultivated  cherries  are 
probaljly  poisonous  to  cattle  in 
the  same  way. 

VICIACE.E    (pea    family). 

Aragallus     lambertii.  —  The 

Lambert,  or  stemless  loco  weed, 
is,  next  to  the  following  species, 
the  best-known  representative  of 
a  large  group  of  closely  related 
plants  which  are  native  to  the 
western  half  of  the  United  States, 
and  are  known  as  loco  weeds  on 
account  of  the  peculiar  excited 
condition  wdiicli  they  induce 
in  animals  that  eat  of  their 
leaves.  Horses  and  cattle  are  both 
affected,  but  the  chief  damage  is 
done  to  horses.  After  being  per- 
mitted to  graze  on  any  of  these 
plants  the  animal  acquires  an  un- 
natural appetite  for  them,  and  soon  refuses  all  other  kinds  of  food.  It 
rapidly  becomes  unmanageable,  shows  brain  symptoms,  and  finally  dies 
from  lack  of  proper  nourishment. 

Astragalus  mollissimus. — This,  the  woolly  loco  weed,  is  perhaps  the 
best  known  of  all  the  loco  weeds.  It  is  the  species  most  abundant  in 
Colorado,  where  from  1881  to  1885  nearly  $200,000  was  paid  out  in 
l)ounties  in  an  attempt,  to  exterminate  it.  The  plant  is  still  abundant 
in  that  State,  and  reports  of  the  damage  done  by  it  continue  frequent. 


Fig.  87. — Black  cherry  {I'rKniis  serotina), 
one-third  natural  size. 


Fig.  88. — White  loco  weed  [Argallus  spicatus)  in  tiower. 
(From  the  Annual  Report,  U.S.A.  Department  of  Agriculture,  1900.) 


Fig.  89. — "White  loco  weed  (Aryallas  *7)/(•((//^s),  showing  seed  pods, 
(From  the  Annual  Report,  U.S.A.  Department  of  Agriculture,  1900. 


Fici.  90. —  IjOCO  weed  [Astragalus  splendcns). 
(From  the  Annual  Report,  U.S.A.  Department  of  Agriculture,  19U0.) 


PLANTS'  POISONOUS   TO   STOCK. 


237 


Specimens  of  the  three  following  species  of  Astragalus  have  been  for- 
warded to  the  Division  of  Botany  with  the  information  that  they  were 
causing  great  financial  loss  in  the  districts  noted.  It  is  quite  probable 
that  other  species  are  dangerous  also. 

POISONING    BY    WHITE    LOCO    WEED    (aEAGALLUS    SPICATUS). 

This  is  an  erect  tufted  perennial,  4  to  18  inches  high,  with  pinnately 


Fig.  91. — Steinless  loco  weed 
{Aragallus  lamhertii).  a, 
Flowering  plant;  h,  seed 
pods ;  c,  cross-section  of 
seed  pod  —  all  one  -  third 
natural  size. 


\ 


Mm\W 


\j  ^ 


Fig.  92. — Woolly  loco  weed  (Asfragalws 
v2ollissimus).  a,  Whole  plant ;  b,  sec- 
tion of  pod — both  one-third  natural 
size. 


divided  leaves  and  spikes  of  white  or  cream-coloured  flowers,  shaped  like 
those  of  the  pea.  The  pod  is  one-celled,  and  when  shaken  produces  a 
rattling  sound,  which  gives  the  plant  the  name  of  "  rattle  weed  "  in  some 
localities.  The  white  loco  weed  is  exceedingly  common  throughout  Mon- 
tana. It  occurs  most  abundantly  on  the  northern  slopes  of  foothills  up 
to  an  altitude  of  about  8,000  feet.     Its  preferred  habitat  is  for  the  most 


238  POISONING. 

part  in  rather  drj-  situations.  The  habit  of  the  plant  varies  in  different 
parts  of  Montana.  In  some  localities  the  flowers  are  pure  white,  while 
in  others  they  are  decidedly  yellow. 

In  Colorado  the  plant  which  is  most  ordinarily  known  as  loco  weed 
is  Astragalus  mollissimus,  while  in  Montana  the  species  already  named  is 
perhaps  most  important ;  but  there  are  others  which  have  a  rather  wide 
distribution  and  are  known  to  produce  the  same  efifects.  Among  these 
may  be  mentioned  A.  splendens,  A.  lagopus,  and  .4.  hesseyi. 

The  losses  caused  from  the  loco  disease  are  very  heavy  in  nearly  all  the 
Eocky  Mountain  States.  The  locoed  condition  is  so  commonly  observed 
among  sheep  and  horses  that  cases  are  not  reported,  and  it  is  practically 
impossible  to  learn  the  exact  extent  of  the  disease.  In  the  Judith  Basin 
one  prominent  stockman  was  nearly  ruined  financially  by  the  prevalence 
for  a  number  of  years  of  the  loco  habit  among  his  sheep.  In  another 
instance  the  raising  of  horses  was  abandoned  over  a  large  tract  of 
country  on  account  of  the  loco  weeds. 

The  loco  disease  occurs  under  two  forms — an  acute  and  a  chronic. 
An  acute  case  of  loco  disease  was  observed  by  Dr.  Wilcox  in  a  two-year- 
old  ewe  with  a  lamb  at  its  side.  The  ewe  was  observed  eating  large 
quantities  of  white  loco  weed  on  May  22nd,  1900.  During  the  afternoon 
of  the  same  day  it  became  unmanageable,  and  the  lamb  was  badly 
afifected.  An  examination  of  the  ewe  at  this  time  showed  that  it  was 
completely  blind  and  was  affected  with  dizziness.  It  walked  around  in 
long  circles  to  the  right,  and  after  a  short  period  remained  standing  for 
a  few  moments  in  a  sort  of  stupor.  At  the  beginning  of  each  attack 
the  head  was  elevated  and  drawn  to  the  right ;  eyelids,  lips,  and  jaws 
were  moved  rapidly.  Each  attack  lasted  from  one  to  two  minutes* 
and  the  intervals  between  the  attacks  lasted  about  five  minutes.  The 
second  day  the  attacks  became  more  severe  and  of  longer  duration,  the 
head  being  turned  more  decidedly  to  the  right  and  the  animal  sometimes 
falling  upon  the  ground.  Similar  symptoms,  accompanied  by  digestive 
disturbances,  were  manifested  by  the  lamb  during  the  second  day,  and  it 
died  during  the  afternoon.  On  the  morning  of  the  third  day  it  was 
found  that  the  ewe  was  pushing  against  the  fold,  and  had  apparently 
been  in  that  position  during  the  greater  portion  of  the  night.  The 
animal  then  began  to  whirl  round  to  the  right.  Later  it  became  unable 
to  stand,  and  the  spasmodic  movements  were  largely  confined  to  the  legs. 
On  the  morning  of  the  fourth  day  it  died.  The  pupil  of  the  eye  was  at 
no  time  dilated,  and  the  expression  was  nearly  normal.  The  pulse  was  at 
first  very  irregular,  but  on  the  second  day  became  again  regular  and  of 
normal  frequency.  The  only  remedy  which  was  tried  was  frequent 
injections  of  one-quarter  grain  doses  of  morphine,  but  this  was  without 
effect.     Two  other  ewes  ate  smaller  quantities  of  loco  weed  at  the  same 


PLANTS   POISONOUS   TO   STOCK.  239 

time  and  were  similarly  affected,  but  less  severely.  In  these  cases 
morphine  was  tried  with  better  success.  The  lambs,  however,  died  from 
the  poisonous  properties  contained  in  the  milk  of  the  mother. 

The  general  symptoms  of  loco  disease  are  quite  familiar  to  all  stock 
raisers.  Perhaps  the  most  characteristic  are  those  of  cerebral  origin,  and 
are  shown  in  peculiarities  of  gait  and  action,  w^hich  may  be  compared  to 
a  drunken  condition.  The  brain  disturbances  may  consist  in  impairment 
of  the  special  senses  or  in  irregular  motor  impulses,  which  produce  inco- 
herent muscular  action.  In  some  cases  the  animal  becomes  blind.  More 
frequently  the  animal  makes  errors  in  judgment  of  the  size  and  distance 
of  objects.  These  visual  disturbances  are  often  quite  ludicrous.  The 
animal  often  takes  fright,  apparently  at  imaginary  objects,  or  at  objects 
which  under  ordinary  circumstances  would  cause  no  alarm.  Locoed 
horses  are  somewhat  dangerous  for  driving  purposes  on  account  of  their 
tendency  to  run  away.  Such  horses  are  frequently  attacked  with  kicking 
fits  without  any  apparent  cause.  The  sense  of  hearing  is  often  affected, 
and  the  response  to  sounds  is  irregular  and  out  of  proportion  to  the 
volume  and  character  of  the  sound.  Irregularities  in  muscular  move- 
ments of  sheep  may  assume  a  variety  of  forms.  The  animal  may  simj)ly 
carry  its  head  in  an  extended  or  otherwise  unnatural  condition.  In  some 
cases  the  back  is  arched.  Trembling  is  a  characteristic  symptom.  In 
locoed  horses  a  great  difficulty  is  sometimes  experienced  in  persuading 
them  to  go  backward.  Locoed  sheep  are  exceedingly  difficult  to  manage. 
The  different  members  of  the  flock  may  suddenly  take  a  notion  to  run 
away  in  different  directions,  with  the  result  that  it  is  almost  impossible 
for  the  shepherd  to  prevent  their  becoming  separated.  In  cattle  the 
disease  appears  to  be  rare,  although  symptoms,  so  far  as  observed, 
are  essentially  the  same  as  those  in  sheep  and  horses.  Occasionally 
locoed  cattle  manifest  dangerous  symptoms,  and  attack  men  and  other 
animals. 

In  chronic  cases  of  loco  the  animal  gradually  becomes  more  emaciated 
and  crazy.  In  sheep  the  fleece  may  be  shed  in  patches  or  as  a  whole. 
The  animal  becomes  unable  to  care  for  itself,  and  is  apt  to  fall  into  the 
water  while  attempting  to  drink.  Fits  of  trembling  are  of  frequent 
occurrence,  and  the  animal  finally  dies  of  inadequate  nutrition  and  total 
exhaustion.  In  chronic  cases  of  loco  disease  in  horses  the  animal  is 
usually  left  to  its  own  resources  on  the  range.  During  the  later  stages 
it  may  remain  for  weeks  at  a  time  upon  a  small  area  of  ground  without 
taking  water.  Dr.  Wilcox  saw  a  number  of  such  cases  in  horses  that 
were  almost  unable  to  walk.  Under  such  circumstances  the  animals 
seldom  or  never  lie  down.  One  horse  which  was  seen  remained  for  a 
period  of  two  weeks,  in  1897,  upon  a  piece  of  ground  about  150  feet 
square.     During  this  time  the  horse  had  no  water. 


240  POISONING. 

Numerous  autopsies  on  locoed  sheep  and  horses  revealed  slight  con- 
gestion of  the  brain  membranes  in  all  cases.  The  lungs  and  heart  were 
in  normal  condition.  Fatty  tissue  was  considerably  reduced  in  quantity, 
and  the  muscles  were  paler  in  colour  than  under  normal  conditions. 

The  most  serious  mistake  in  connection  with  loco  disease  is  made  in 
allowing  locoed  sheep  to  remain  with  the  rest  of  the  flock.  The  loco 
habit  is  apparently  learned  by  imitation  of  locoed  animals,  and  so  long 
as  locoed  sheep  are  allowed  to  remain  with  other  sheep  the  loco  habit 
rapidly  spreads.  An  experienced  sheep  raiser,  after  being  nearly  ruined 
financially  through  the  loco  disease,  adopted  the  method  of  immediate 
isolation  and  the  feeding  of  locoed  sheep  for  mutton.  His  stock  was 
replaced  with  sheep  that  were  free  from  the  loco  habit,  and  the  trouble 
has  been  entirely  eradicated  from  his  range. 

No  specific  remedy  for  the  loco  disease  has  been  discovered,  and  in 
the  nature  of  the  case  no  such  remedy  is  likely  to  be  found.  In  the 
present  state  of  knowledge  concerning  the  subject  the  only  rational 
treatment  to  be  recommended  is  that  of  confinement  and  feeding  with  a 
nutritious  diet.  By  separating  the  locoed  sheep  at  once  from  other  sheep 
the  spreading  of  the  habit  will  be  prevented,  and  the  locoed  animals  may 
be  fattened  and  thus  prevented  from  becoming  a  total  loss.  Although 
locoed  animals  may  readily  be  fattened  and  sold  for  mutton,  their 
recovery  from  the  loco  habit  is  apparent  only,  and  is  due  to  their 
inability  to  obtain  the  loco  weed.  Such  animals  when  allowed  to  run 
upon  the  range  again  almost  invariably  return  to  their  old  habit  of 
eating  loco  weed.  Animals  which  have  once  been  locoed  are,  therefore, 
unsuitable  for  stocking  the  range. 

In  combatting  the  loco  disease  the  most  rational  methods  include 
providing  salt  for  the  sheep,  the  immediate  removal  of  locoed  sheep 
from  the  band,  confining  them  in  a  fold,  and  feeding  them  upon  a 
nutritious  diet.  They  may  thus  be  fed  for  market,  and  their  pernicious 
habit  will  not  spread  to  other  sheep.  In  the  case  of  locoed  horses,  an 
apparent  recovery  takes  place  if  they  are  confined  in  a  stable  and  fed  on 
ordinary  cultivated  forage  or  allowed  to  run  in  pastures  where  no  loco 
weeds  are  found.  Such  horses  are  always  somewhat  dangerous,  and 
more  apt  to  run  away  or  become  unmanageable  than  horses  which  have 
not  become  affected  with  this  disease. 

*  Crotalaria  sagittalis. — The  rattlebox  (rattle  weed ;  wild  pea)  is  an 
annual  weed  which  grows  on  sandy  soil  throughout  most  of  the  eastern 
half  of  the  United  States.  In  some  jeavH  it  is  especially  abundant  in  the 
bottom  lands  of  the  Missouri  Valley.  Horses  and  sometimes  cattle  are 
killed  in  this  region  by  eating  grass  or  meadow  hay  which  is  contami- 
nated with  the  plant. 


PLANTS   POISONOUS   TO    STOCK. 


241 


Lupinus  leucophyllus. — This  herbaceous  shrub  is  a  representative  of 
a  very  large  genus  of  plants,  many  of  which  are  widely  and  abundantly 
distributed  throughout  the  western  United  States,  and  are  generally 
known  as  lupines.  The  above  species  is  very  abundant  in  Montana, 
where  it  is  said  to  have  caused  the  death  of  a  very  large  number  of 
sheep.  There  is  some  question  whether  the  animals  are  killed  by  a 
poisonous  constituent  of  the  plant 
or  merely  by  tympanites.  The  seeds 
of  all  the  lupines  are  probably  dele- 
terious in  the  raw  state.  In  Europe, 
however,  the  seeds  of  Lupinus  alius, 
after  the  bitter  taste  has  been  re- 
moved by  steeping  and  boiling,  are 
eaten  by  human  beings  as  well  as 
by  cattle. 

POISONING       BY       LUPINES        (lUPINUS 
LEUCOPHYLLUS  ;      L.     SEPvICEUS  ;     L. 

CYANEUS). 

These  plants  are  commonly 
known  by  the  names  blue  pea, 
blue  bean,  and  wild  bean.  They 
are  coarse,  silky-haired  perennial 
herbs,  with  blue  flowers  arranged 
in  conspicuous  terminal  racemes, 
which  blossom  in  June  and  July, 
with  long- stemmed  leaves,  which 
are  divided  into  from  seven  to 
eleven  leaflets  radiating  from  a 
common  point.  The  fruit  is  a  hairy, 
several-seeded  pod,  and  the  seeds 
are  small  and  somewhat  flattened. 

As  a  rule  these  plants  do  not 
occur   in    the    flat    river    bottoms. 

They  occur  most  abundantly  on  the  foothills  and  mountain  ranges  at 
moderate  elevations. 

During  the  season  of  1900  the  lupines  in  Montana  began  to  bloom 
about  May  20th,  and  the  first  full  pods  were  collected  on  June  5th. 
Lupines  are  not  very  extensively  eaten  by  sheep  during  the  spring  and 
summer,  except  when  they  are  unusually  hungry  or  are  being  driven 
from  one  range  to  another.  Lupines  are  more  often  eaten  by  sheep  in 
summer  on  the  mountain  sides,  and  in  the  fall  and  early  winter  after 

D.C.  R 


Fig.  93. — Rattle  box  {Crotalaria  saglt- 
talis).  rt,  Whole  plant;  &,  cross-section 
of   seed  pod— both  one-third  natural 

size. 


242  tOlSONlNG. 

early  frosts  have  opened  the  pods  and  the  seeds  have  fallen  out.  Lupine 
hay  is  greedily  eaten  by  all  kinds  of  stock  during  the  winter,  and  large 
quantities  of  this  hay  have  been  fed  for  the  past  fifteen  or  twenty  years. 
Lupine,  hay  is  cut  in  different  jeavs  at  dates  ranging  from  the  1st  of 
July  to  the  middle  of  September.  "When  cut  during  the  first  half  of  July 
the  newl}'  ripe  pods,  full  of  seeds,  are  secured  in  the  hay.  When,  how- 
ever, the  harvesting  of  luj)ine  hay  is  postponed  until  September,  the 
pods  become  ripe  and  split  open,  and  the  majority  of  seeds  fall  out.  A 
striking  variation  in  the  quantity  of  pods  containing  seeds  is  noted 
during  different  years.  Daring  seasons  in  which  May  and  June  are  wet. 
the  quantity  of  pods  is  usually  large.  When,  however,  these  months  are 
dry  only  a  few  pods  are  found  on  each  phmt,  and  a  vast  majority  of  the 
flowers  fail  to  be  fertilised. 

Dr.  Wilcox  has  observed  that  sheep  are  especially  fond  of  the  pods  of 
various  leguminous  jjlants  before  they  become  mature  and  while  they  are 
still  in  a  succulent  condition. 

Dr.  Wilcox  saw  a  flock  of  sheep  which  while  being  driven  from  one 
range  to  another,  in  a  hungry  condition,  was  allowed  to  feed  upon  an 
area  of  lupines  in  a  nearly  ripe  condition.  Within  two  hours  the  sheep 
manifested  violent  symptoms  of  poisoning,  and  ultimately  100  out  of  the 
lot  of  200  died.  He  afterwards  saw  many  hundreds  of  fatal  cases  in 
sheep  and  a  number  in  horses,  both  from  eating  green  lupines  and 
lupine  hay. 

As  an  experiment  two  sheep  were  given  each  150  medium-sized 
lupine  pods  (L.  leucophijllus)  which  were  entirely  full  of  ripe  seeds.  The 
sheep  ate  the  pods  readily.  Both  sheep  became  frenzied  within  about 
forty-five  minutes  after  feeding  upon  the  lupine  pods,  and  died  al)0ut  one 
hour  later.  The  symptoms  in  these  cases  were  the  same  as  those 
observed  in  poisoning  under  natural  conditions. 

The  symptoms  of  lupine  poisoning  are  so  well  known  in  Europe 
that  chronic  lupine  poisoning  has  been  given  the  name  liipinosis.  It  is 
characterised  hj  loss  of  appetite,  fever,  dyspnoea,  constipation,  and  yellow- 
ness of  the  visible  mucous  membranes.  Diarrhoea,  sometimes  of  a  san- 
guinolent  type,  appears  later.  The  urine  becomes  albuminous,  tinted  with 
bile  products  or  stained  red  by  hii:;moglobin,  and  the  head  shows  oedema. 
Death  occurs  in  a  few  days.  In  America  the  chronic  form  has  not  been 
observed.  In  cases  of  lupine  poisoning  in  Montana  there  was  noted 
acute  cerebral  congestion,  accompanied  with  mental  excitement.  The 
sheep  rushed  about  in  different  directions,  butting  one  another  and  other 
objects.  The  first  stage  of  frenzy  was  soon  followed  by  a  second  stage, 
characterised  by  pronounced  irregularity  of  movement,  spasms,  and 
falling  fits.  In  the  majority  of  cases  death  occurred  in  from  one-half  to 
one  and  one-half  hours.     In  extensive  cases  of  lupine  poisoning  it  was 


Fig.  94. — Lupine  (Lupinus  leucophijUus). 
(From  the  Annual  Report,  U.S.A.  Department  of  Agriculture,  1900.) 


Fig.  95. — Lupine  {Lupiuus  lfiir,,/ilii/lh(.s)  in  hav. 
(From  the  Annual  Report,  U.S.A.  Department  of  Agriculture,  1900. 


PLANTS  POISONOUS  TO  STOCK.  243 

uniformly  observed  that  a  number  of  the  sheep  lingered  on  from  two  to 
four  days  before  they  died.  The  muscular  convulsions  resembled  those 
caused  by  strychnme.  The  excretion  of  the  kidneys  was  much  increased 
and  frequently  was  bloody.  Post-mortem  examinations  of  sheep  poisoned 
by  lupines  revealed  conditions  similar  to  those  in  acute  forms  of  loco 
disease,  with  the  addition  of  a  congested  condition  of  the  kidneys. 

No  remedies  have  been  tried  in  cases  of  jDoisoning  from  American 
species  of  lupine,  but  it  seems  reasonable  to  suppose  that  potassium 
permanganate  would  probably  destroy  the  lupine  alkaloids  in  the  stomach 
if  administered  promptly  after  the  first  signs  of  poisoning.  Experience 
and  observation  indicate  that  lupine  hay  is  always  dangerous  for  sheep  if 
cut  at  a  time  when  the  seeds  are  retained  in  the  hay.  The  evidence  thus 
far  collected  regarding  this  matter  indicates  that  the  seeds  are  the  most 
poisonous  part  of  the  plant. 

POISONING    BY    VETCHES    (lATHYRUS    SATIVUs)  :    LATHYRISM. 

In  the  horse  this  disease  is  due  to  feeding  on  grain  containing 
the  seeds  of  vetches,  but  in  the  ox  to  eating  the  green  portions  of  the 
plants.  Feeding  has  to  be  continued  for  at  least  a  month  to  produce 
accidents. 

The  earliest  symptoms  consist  in  suppression  of  milk  secretion,  and 
somnolence.  Nervous  symptoms — -from  which  alone  the  horse  suffers — • 
soon  make  their  appearance.  The  neuro-muscular  system  is  attacked. 
Interference  with  the  nervous  system  is  followed  by  inco-ordination  of 
movement,  and  later  by  paraplegia  of  the  hind  quarters.  Eoaring  is  not 
noticeable,  probably  because  the  patients  rarely  move  rapidly. 

The  lesions  have  been  little  studied,  but  appear  to  consist  in  con- 
gestion and  infiltration  of  the  meninges,  cord,  and  roots  of  the  lumbo- 
sacral plexus. 

Treatment.  If  the  animals  are  paralysed,  treatment  is  rarely  of 
value ;  otherwise  it  is  sufficient  to  remove  the  cause  and  to  administer 
purgatives  and  diuretics,  with  the  object  of  eliminating  toxic  products. 
Eecovery  follows  in  three  to  four  weeks. 

Robinia  pseudacacia. — The  common  locust  tree  is  native  in  the 
central  and  eastern  parts  of  the  United  States,  and  is  extensively 
cultivated  for  ornamental  purposes  throughout  the  Union.  The  bark 
and  leaves  contain  a  powerful  poison,  and  persons  have  been  killed  by 
eating  these  parts. 

*  Sophora  secundiflora. — The  beautiful  bright-red  beans  of  the  frijo- 
lillo,  or  coral  bean,  of  southern  and  western  Texas  contain  a  powerfully 
poisonous  alkaloid.  The  plant  is  said  to  have  poisoned  stock  in  Texas 
and  in  northern  Mexico. 

R  2 


244 


POISONING. 


L1NACE.E    (FLAX    FAMILY). 

Linum  rigidum. — The  large-flowered  yellow  flax  is  reported  from 
Pecos  Valley,  Texas,  as  poisonous  to  sheep.  An  investigation  made  by  the 
Bm-eau  of  Animal  Industry,  U.S.A.,  showed  that  the  plant  is  poisonous. 


Hi,^ 


Fig.  96. — Caper  spurge  {Evphorbia 
lathijris).  a,  Upper  half  of  plant, 
one-third  natural  size ;  b,  seed 
capsule,  natural  size. 


Fig.  97. — Snow  on  the  mountain  {Eu- 
pliorhia  marginata).  a,  ^Yhole  plant^ 
one-third  natural  size;  b,  seed  capsule, 
natural  size. 


MELIACE.E    (UMBRELLA-TEEE     FAMILY). 

*  Melia  azedarach. — ^The  Chinese  umbrella  tree  is  much  cultivated 
for  ornament,  and  sometimes  grows  wild  in  the  South.  A  correspondent 
from  Arizona  stated  that  three  of  his  hogs  were  poisoned  by  eating  the 
seeds,  which  were  ignorantly  offered  to  them  for  food. 


EUPHORBIACE.E    (SPURGE    FAMILY"). 

Euphorbia. — There  are  many  species  of  spurge  native  to  the  United 
States,  nearly  all  of  which  contain  an  acrid  milky  juice.     Stock  generally 


PLANTS   POISONOUS   TO   STOCK. 


245 


avoid  them,  but  cattle  have  been  poisoned  by  drinking  water  into  which 
the  plants  have  been  throwai.  The  juice  of  E.  mavcjinata  and  E.  hkolour 
is  used  to  some  extent  in  Texas  to  brand  cattle,  it  being  held  to  be 
superior  to  a  red-hot  iron  for  that  purpose,  because  screw  worms  will  not 
infect  the  fresh  scar  and  the  spot  heals  more  readily. 

*  Jatropha  stimulosa. — The  seeds  of  the  spurge  nettle  of  the  Southern 
States  are  extremely  poisonous.  Stock  avoid  the  plant  on  account  of  its 
stinging  hairs. 

*  Ricinus    communis.  —  The   castor   oil    plant    is    quite    commonly 


Fig.  98. — Castor  oil  plant  {Ricinm 
comtntmis). 


Fig.  99. — Eed  chestnut  {^■Escnliis  pavia). 
a,  Flowering  branch ;  h,  seed— both 
two-ninths  natural  size. 


cultivated  in  the  warmer  portions  of  the  United  States,  and  grows 
wild  in  the  South.  The  seeds  have  been  accidentally  eaten  by 
horses  with  fatal  effect,  and  they  have  been  strewn  on  pasture  lands 
in  the  North-West  for  the  purpose  of  killing  sheep  that  w^ere  tres- 
passing thereon.  A  Frenchman  has  discovered  a  method  of  making 
cattle  immune  to  the  effects  of  the  toxalbumin  contained  in  the 
seeds,  so  that  they  may  be  fed  to  stock  without  causing  any  ap- 
parent ill  effect.  A  note  on  poisoning  by  castor  oil  cake  will  be 
found  hereafter. 


246 


POISONING. 


*  Buxus  sempervirens 

for  hedges,  are  poisonous  to  all  kinds  of  stock 


A.CEiE    (box    family). 

The  leaves  of  the  common  hox,  cultivated 


^.scuLAcr.  (horse-chestnut  family). 


iEsculus    californica,  California 


Fig.  100. — "Water  hemlock  {Cicu fa  niacu- 
lata),  showing  section  of  spindle-shaped 
roots  and  lower  stem,  the  leaves,  flowers, 
and  fruit,  one-half  natural  size  ;  also  fruit 
and  cross-section  of  seed,  enlarged  five 
times. 

which  contained  nearly  50  per  cent. 
from  the  effects  of  the  poison,  and 
further  suffering. 


huckeye :  M.  glabra,  Oiiio  buck- 
eye ;  fcetid  buckeye :  M.  hippo- 
castanum,  horse  -  chestnut :  M. 
paYia,  red  buckeye. — The  leaves 
and  fruit  of  these  species  are 
generally  regarded  as  poisonous 
to  stock.  The  fruit  may  be  easily 
converted  into  food  by  \Yashing 
and  boiling.  It  is  believed  that 
a  small  quantity  of  the  unpre- 
pared fruit  of  the  California  buck-* 
eye  will  cause  cows  to  slip  their 
young. 

hypericace^  (st.  John's  wort 
family). 

*  Hypericum    perforatum. — 

The  common  St.  John's-wort  is 
commonly  believed  to  cause  dis- 
agreeable eruptions  on  cows' 
udders  and  on  the  feet  of  white 
haired  animals.  This  species 
and  the  spotted  St.  John's  wort 
(H.  inaculatu))i)  were  brought  into 
the  United  States  Bureau  of  Agri- 
culture by  Dr.  G.  W.  Bready,  from 
Norwood,  Maryland,  who  stated 
that  five  horses  were  poisoned  in 
May,  1808,  by  eating  meadow  hay 
of  these  plants.  One  horse  died 
two  were  killed  to  prevent  their 


POISONING    ]{Y    ST.    JOHN  S    WORT. 

The  ingestion  of  St.  John's  wort  produces  excitement  followed  ))y  dul- 
lness, interference  with  vision  and  hearing,  and  by  visual  hallucinations 


PLANTS   POISONOUS   TO   STOCK. 


247 


with  a  tendency  to  lean  backwards,  the  front  Kmbs  remaining  fixed  in 
position.     The  patient  often  sits  down  on  the  hind  quarters  Hke  a  dog. 

APIACE^    (carrot    family). 

*  Cicuta  maculata.      This  is  the  water  hemlock  (spotted  hemlock  ; 
beaver  poison  ;  cowbane),  which  grows  most  abundantly  throughout  the 


Fig.  101. — Orepfon  water  hemlock  {Cicuta 
vagans).  a,  Plant  with  leaves,  one-sixth 
natural  size  ;  b  and  6\  rootstock  and 
horizontal  roots,  showing  section,  half- 
size  ;  c,  terminal  leaflets,  one-sixth  na- 
tural size  ;  d,  flowering  spray,  full  size. 


Fia.  102. — Poison  hemlock  [Coniioii  mac- 
jdatnni),  showing  upper  portion  of 
plant  with  flowers  and  seed,  one-third 
natural  size. 


United  States.  It  is  one  of  the  best  known  poisonous  plants.  Stock  are 
not  infrequently  killed  by  eating  the  fleshy  roots  or  hay  with  which  the 
plants  are  mixed. 

*  Cicuta    vagans.  —  Cattle    are   frequently    killed    in    Oregon    and 
Washington   by  eating   the   large   fleshy  rootstocks   which   have   been 


248 


POISONING. 


washed,  frozen,  or  dug  out  of  the  soil,  or  b}-  drinking  water  in  marshes 
where  the  roots  have  been  trampled  upon.  The  roots  of  the  other 
species  of  Cicuta  are  undoubtedly  poisonous,  but  cases  have  been 
reported  against  one  other  species  only,  namely,  C.  hohmdcri.  It  grows 
in  marshy  land  in  California. 

*  Conium  maculatum. — The  well-known  poison  hemlock,  or  spotted 
hemlock  of  Europe,  is  an  introduced  weed  not  uncommon  in  the  north- 
eastern  section  of  the  United  States  and  in  California.     The  plant  is 


Fig.  103.  —  Narrow-leaf 
laurel  (Kalviia  an- 
gustifolia),  showing 
flowering  branch,  one- 
third  natural  size. 


Fig.  104. — Broad-leaf  laurel  (Kalmia  latifoUa). 
a,  Flowering  spraj',  one-third  natural  size ; 
h,  vertical  section  of  flower  showing  pecu- 
liar attachment  of  stamens,  natural  size  ;  c, 
fruiting  capsules,  natural  size. 


generally  avoided  by  stock  on  account  of  its  bad  odour,  but  animals 
have  been  killed  by  eating  it  in  the  fresh  state.  Since  the  poisonous 
constituent  is  volatile,  the  dry  plants  are  not  so  dangerous. 


POISONING    BY    HEMLOCK    AND    WILD    CHERVIL    (aNTHRISCUS    SYLVESTRIS). 

Poisoning  only  results  from  ingestion  of  the  green  plants.  It  is 
characterised  by  salivation,  nausea,  dyspnoea,  generalised  trembling  and 
vertigo,  paraplegia,  and  symptoms  of  gastro-enteritis, 


PLANTS   POISONOUS   TO   STOCK. 


249 


POISONING    BY    FENNEL. 

This  disease,  seen  in  Algeria,  and  recently  studied  by  Bremond  and 
Bojoly,  need  only  be  mentioned.     The  information  at  present  available 
is  indefinite,  and  the  symptoms  so  closely  resemble  those  of  Texas  fever 
that   there   seems  a  possibility  of 
confusion  having  arisen. 

The  lesions  are  those  of  hemor- 
rhagic gastro-enteritis. 

Treatment  consists  in  giving 
tannin,  opium,  and  emollients, 

Oxypolis  rigidus. — The  cowbane 
is  natural  in  swamps  throughout 
the  eastern  half  of  the  United 
States.  The  leaves  and  roots  are 
reputed  to  be  poisonous  to  cattle. 

Slum  cicutsefolium. — The  leaves 
of  the  hemlock  water  parsnip,  which 
is  more  or  less  common  throughout 
the  United  States,  are  said  to  be 
poisonous  to  stock. 


ERICAE^    (heath    FAMILY). 

Andromeda   poli folia.  —  The 

wild  rosemary,  or  moorwort,  is  a 
plant  native  to  the  northern  regions 
of  Europe,  Asia,  and  America,  en- 
tering the  United  States  only  in 
the  extreme  north-east.  The  leaves, 
which  have  been  eaten  by  sheep 
with  fatal  effect,  contain  a  narcotic  poison  known  as  andromedotoxin. 
The  plant  is  not  very  dangerous  in  its  native  habitat,  because  it  grows 
in  bogs  which  are  inaccessible  to  stock. 

*  Azalea  occidentalis. — The  California  azalea  is  very  much  dreaded  by 
sheep  men  who  drive  their  flocks  into  the  southern  Sierras  for  pasture. 
Investigation  has  shown  that  the  leaves  contain  a  poisonous  substance. 

*  Kalmia  angustifolia. — The  narrow-leaf  laurel  is  abundant  in  the 
north-eastern  section  of  the  United  States,  where  it  is  also  well  laiown 
as  sheep  laurel  and  lamb-kill.  The  leaves  contain  andromedotoxin, 
and  sheep  and  calves  are  frequently  poisoned  by  eating  them. 

*  Kalmia  latifolia. — The  broad-leaf  laurel  is  native  throughout  the 
greater  part  of  the  eastern  half  of  the  United  States,  and  is  known  by 


Fig.  105. — Branch  ivy  (Leiicothoc  cates- 
hcei).  a,  Flowering  branch  ;  &,  fruiting 
capsules. 


250 


POISONING. 


a  great  variet}'  of  common  names,  the  most  important  of  which  are 
laurel  and  iv^.  The  latter  name  is  most  commonly  used  south  of  Mary- 
land. Scores  of  cattle  and  sheep  are  poisoned  annually  by  eating  the 
plant.  It  is  pro])a1)ly  the  most  dangerous  of  all  the  shrubs  belonging 
to  the  heath  family. 

*  Leucothoe  catesbaei. — This  is  the  branch  ivy,  hemlock,  or  calf-kill, 


Fig.  106. — Staggerbush  (Pieris  mari- 
ana),  showing  flowering  branch, 
one-third  natural  size. 


Fig.  107. — Great  laurel  {Ithododcndron  maxi- 
mum). (7,  Flowering  branch  ;  b,  fruiting 
capsules — both  one-third  natural  size. 


of  the  Allegheny  Mountains.    It  is  well  known  in  that  region  to  be  fatal 
to  all  kinds  of  stock. 

*  Leucothoe  racemosa. — The  swamp  Leiicothoi'  of  the  Atlantic  and 
Gulf  States  has  l)een  reported  from  New'  Jersey  as  especially  fatal  to 
calves. 

*  Pieris  mariana. — The  stagger  bush  of  the  Atlantic  Coast  region, 
Tennessee,  and  Arkansas  is  commonly  know'ii  to  be  poisonous  to 
calves  and  to  sheep.  The  name  stagger  bush  was  applied  to  the 
shrub  on  account  of  the  peculiar  intoxicating  effect  of  the  leaves. 

*  Rhododendron    californicum.  —  The    California    rhododendron    is 


PLANTS    POISONOUS    TO    STOCK. 


251 


native  on  the  Pacific  Slope  from  San  Francisco  to  British  CoUimbia. 
The  phmt  is  reported  from  Oregon  as  poisonous  to  sheep.  It  is  quite 
probable  that  the  leaves  contain  andromedotoxin,  but  they  have  not 
been  tested. 

*  Rhododendron  maximum. — The     great    hiurel     (i-osebay  ;    moun- 
tain laurel ;  rhododendron)  is  a  large  evergreen  bush  or  small  tree  which 
is  quite  commonly  cultivated  for  ornament,  and 
is  found  native  in  the  Allegheny  Mountains.     The 
leaves  contain  andromedotoxin,  and  they  are  occa- 
sionally eaten  by  stock  with  fatal  effect. 

PRIMULACE,^    (primrose    FAMILY). 

Anagallis  arYensis.  —  The  pimpernel  is  a 
European  plant  which  has  obtained  a  specially 
strong  foothold  in  California,  where  it  grows 
luxuriantly  and  is  sometimes  known  as  poison 
weed.  It  is  suspected  of  having  caused  the  death 
of  a  horse  at  Santa  Ana.  Chemists  have  isolated 
a  powerfully  poisonous  oil  and  a  strongly  active 
ferment  from  the  plant. 

OLBACE.'E    (olive    FAMILY). 

Ligustrum  vulgare. — The  privet,  or  prim,  is 
a  garden  shrub,  introduced  from  Europe  and 
Asia,  which  is  much  used  for  hedges,  and  has 
escaped  from  cultivation  in  western  New  York 
and  southward  to  North  Carolina.  Accidents  have 
been  occasioned  in  children  both  by  the  fruit  and 
the  leaves.  The  plant  is  to  be  suspected  in  cases 
of  poisoning  in  animals. 

APOCYNACE.F.    (DOGBANE    FAMILY). 

Apocynum  androsaBmifolium,  spreading  dog- 
bane :  A.  cannabinum,  Indian  hemp.  —  These 
plants   are  generally  distributed  throughout  the 

United  States.  Stock  generally  avoid  them  in  pasture  fields  on  account 
of  their  acrid  milky  juice.  When  dry  they  are  not  so  poisonous  as  when 
in  the  fresh  state. 

Nerium  oleander. — The  oleander  is  a  common  house  plant  throughout 
a  large  portion  of  the  United  States.  It  grows  freely  out  of  doors  in 
the  Southern  and  Western  States,  and  has  probably  escaped  from  culti- 
vation in  some  places.     It  grows  wild  in  northern  Mexico.     The  leaves 


Fig  108.  —  IMilkweed 
{Asdepias  eriocarpa), 
one-sixth  natural  size. 


252 


POISONING. 


are  well  known  to  be  most  powerfully  poisonous,  and  stock  are  occa- 
sionally killed  by  eating  them. 


ASCLEPIADACE.E    (MILKWEED    FAMILY). 


*  Asclepias  eriocarpa. — This  is  the 
leaves  which  is  known  as  milkweed  in 


plant  with  broad  mullein-like 
California.  Several  authentic 
accounts  of  the  poisoning  of 
sheep  have  been  secured 
against  the  plant  in  Men- 
docino County.  It  is  espe- 
cially feared  on  very  warm 
days  by  sheep  men  when 
they  are  compelled  to  drive 
their  flocks  through  dry, 
barren  valleys.  It  sometimes 
grows  on  cultivated  land,  and 
is  cut  with  hay. 

*  Asclepias  syriaca. — This 
is  the  common  milkweed,  or 
silkweed,  of  the  north-eastern 
quarter  of  the  United  States. 
Experiments  show  that  the 
milky  juice  so  abundant  in 
all  parts  of  the  plant  is  very 
acrid  and  poisonous.  It  is 
listed  among  the  poisonous 
plants  of  Europe. 

SOLANACE^    (potato    FAMILY). 

*  Datura  stramonium: 
D.  tatula. — These  two  species 
very  closely  resemble  each 
other,  and  are  most  com- 
monly known  in  the  United 
States  by  the  name  of  jimson 

weed.  They  are  European  plants  which  have  become  weeds  in  waste 
grounds  and  about  dwellings  throughout  the  greater  portion  of  the 
country.  One  or  two  instances  are  recorded  in  which  cattle  have  been 
poisoned  by  eating  hay  containing  the  young  leaves. 

*  Hyoscyamus  niger. — The  black  henbane  is  an  ill-smelling  plant,  a 
native  of  Europe,  now  naturalised  in  Michigan,  and  from  New  York  north- 
ward.  One  or  two  cases  are  recorded  in  European  literature  in  which  stock 


Fig.  109. — Jinisou  weed  {Datura  stramonium). 
a,  Flowering  spra3' ;  b,  fruiting  capsule — both 
one-third  natural  size. 


PLANTS   POISONOUS   TO   STOCK. 


253 


have  been  poisoned  by  eating  the  phxnt  of  their  own  accord,  but  there 
is  very  httle  danger  from  it,  on  account  of  its  ill  odour  and  harsh 
texture. 

*  Nicotiana  tabacum. — This  is  the  tobacco  most  commonly  cultivated 
in  the  United  States.  It  is  native  to  South  America  and  has  escaped 
from  cultivation  to  some  extent  in  the  Southern  States.  According  to 
some  authorities  stock  are  not  always  disposed  to  shun  this  plant  on 
account  of  its  characteristic  ill  odour  and  taste,  but,  on   the  contrary, 


Fig.  110. — Bittersweet  {Solaniim  dulca- 
mara), a,  Flowering  spray  ;  h,  fruit — 
both  one-third  natural  size. 


Fig.  111.— Black  nightshade  {Sola- 
niim nigrum),  one  -  third  natural 
size. 


will  eat  a  small  amount  of  the  leaves  with  apparent  relish,  especially 
when  they  are  somewhat  fresh.  Stock  have,  however,  been  poisoned  by 
eating  leaves  which  were  placed  within  their  reach  to  dry,  and  also  by 
eating  food  contaminated  with  the  juice  of  the  leaves.  Considerable 
precaution  should  be  used  in  applying  tobacco  juice  to  fresh  cuts  or 
bruises  in  stock,  as  the  poison  is  easily  absorbed  into  the  system  and 
may  prove  fatal.      There  are  several  native  species  of  tobacco  in  the 


254 


POISONING. 


western  half  of  the  United  States,  all  of  which  are  undouhtedly  poisonous 
if  eaten  even  in  moderate  quantity. 


-^%  .. 


TOBACCO    POISONING. 

Tohacco  poisoning  may  l)e  produced  hy  haths  or  lotions  containing 
tohacco  juice,  which  is  often  used  as  a  parasiticide.     The  ingestion  of 

tobacco  leaves  in  forage  may  also 
produce  j)oisoning.  Doses  of  1  ounce 
in  the  goat  and  10  ounces  in  the  ox 
are  toxic. 

The  symptoms  consist  in  sali- 
vation, vomiting,  nausea,  diarrhoea, 
cardiac  palpitation  and  dyspnoea. 

The  lesions  are  those  of  gastro- 
enteritis with  cerebral  congestion. 

Treatment  consists  in  giving 
tannin,  black  coffee,  etc. 

Solanum  dulcamara. — The 

bittersweet,  or  climbing  night- 
shade, is  a  European  weed,  now 
introduced  in  the  north  -  eastern 
quarter  of  the  United  States.  The 
leaves  are  suspected  of  being  poi- 
sonous to  stock. 

*  Solanum  nigrum. — The  black 
nightshade  (common  nightshade ; 
garden  nightshade)  is  a  common 
weed  in  cultivated  fields  throughout 
the  greater  portion  of  the  United 
States.  Cattle  seldom  eat  the  plant, 
but  a  few  cases  of  poisoning  are 
recorded  for  calves,  sheep,  goats, 
and  swine. 
*  Solanum  triflorum.— The  spreading  nightshade  is  a  native  of  the 
Great  Plains  (United  States),  and  also  a  common  garden  weed  from 
Arizona  and  Texas  to  Ih-itish  America.  Complaints  of  the  poisoning 
of  cattle  by  this  plant  have  been  sent  to  the  Department  of  Agriculture 
from  Nebraska.     Experiments  show  that  the  berries  are  poisonous. 

Solanum  tuberosum. — The  small,  immature  tubers  of  the  common 
cultivated  potato  and  tliose  that  have  turned  green  from  exposure  to 
the  sun  are  slightly  poisonous.     The  green  fruit  and  tlie  white  sprouts 


Fig.    112. — Spreading  niglitshade   (Sola- 
num trifloriiJii),  one-third  natural  size. 


PLANTS   POISONOUS   TO   STOCK. 


255 


from  mature  potatoes  are  likewise  poisonous.     In  all  of  these  cases  the 
deleterious  suhstance  may  be  removed  or  destroyed  by  thorough  boiling. 


SCROPHULARIACEiE    (fIGWORT    FAMILY). 

Digitalis  purpurea. — The  purple  foxglove  is  a  common  garden  plant 
which  has  sparingly  escaped  from 
cultivation  and  is.  naturalised  to 
some  extent  on  Cape  Breton  Island. 
Horses  are  occasionally  poisoned 
in  Europe  by  nipping  the  plants 
from  gardens  or  by  eating  hay 
contaminated  with  it. 

Gerardia  tenui folia. — The 
slender  gerardia  is  native  to  the 
eastern  half  of  the  United  States, 
and  has  been  specially  reported  as 
poisonous  to  sheep  and  to  calves 
in  the  Southern  States. 

Gratiola  officinalis. — The  hedge 
hyssop  of  the  Southern  States 
contains  an  acrid  poison.  The 
same  plant  grows  in  Europe,  and 
is  there  regarded  as  poisonous  to 
stock. 

Pedicularis. — The  plants  of  this 
genus  are  commonly  called  louse- 
wort.  In  Europe  several  species 
are  suspected  of  being  slightly 
poisonous  to  stock.  One  of  these, 
P.  palustris,  occurs  in  Labrador, 
and  there  are  over  thirty  species 
native  to  the  United  States,  largely 
Western.     They  should  all  be  suspected  of  being  poisonous 


Fig.  113. — Siieezeweed    [Helinuiim  au- 
tainnalc),  one-third  natural  size. 


CAMPANULACE.E    (bELL-FLOWER    FAMILY). 

Lobelia  inflata,  Indian  tobacco :  L.  kalmii,  brook  lobelia :  L.  spicata, 

pale-spiked  lobelia  :  L.  syphilitica,  great  lobelia.- — All  of  the  species  in 
this  genus  contain  an  acrid  and  usually  milky  juice,  and  are  poisonous. 
None  has  been  specially  reported  as  poisonous  to  stock,  but  the  above- 
named  species  are  to  be  suspected,  because  they  fre(j[uently  occur  in 
grass  and  are  sometimes  found  in  meadow  hay. 


256  POISONING. 

AMBROSIACE.E    (ragweed    FAMILY). 

Xanthium  canadense. — The  young  seedlings  of  the  American  cock- 
lebur  are  reported  from  Texas  as  being  rapidly  fatal  to  hogs. 

Xanthium  spinosum. — The  spiny  clotbur  is  suspected  of  being  poi- 
sonous, but  few  cases  have  been  definitely  recorded  against  it.  The 
seeds  apparently  contain  a  toxic  compound. 

Xanthium  strumarium. — The  young  seedlings  of  the  broad  cock- 
lebur  are  reported  from  Georgia  as  being  fatal  to  hogs.  Experiments 
seem  to  show  that  the  seed  is  poisonous. 

CARDUACE.E    (THISTLE    FAMILY). 

*Helenium  autumnale.— Sneezeweed  (sneezewort ;  autumn  sneeze- 
weed;  stagger  weed;  false  sunflower)  is  found  throughout  the  greater 
portion  of  the  United  States,  being  most  abundant  in  the  Southern  and 
Eastern  States.  Sheep,  cattle  and  horses  that  are  unfamiliar  with  the 
plant  are  often  poisoned  by  it  when  driven  to  localities  where  it  is  abun- 
dant. Stock  avoid  it,  as  a  rule,  but  it  is  claimed  that  they  sometimes 
develop  a  taste  for  the  plant,  and  are  killed  quickly  by  eating  it  in  large 
quantity. 

Senecio  jacobaea. — The  tansy  ragwort,  or  stagger  wort,  is  a  European 
plant  which  grows  as  a  weed  in  ballast  about  New  York  and  Philadelphia. 
Farther  north,  in  Nova  Scotia,  it  has  become  extensively  naturalised,  and 
it  is  there  regarded  by  stock  men  as  poisonous.  It  is  interesting  to 
note  that  S.  guadalcnsis  of  Mexico  is  also  considered  fatal  to  stock. 


COLCHICUM    POISONING. 


Fodder  of  bad  quality  often  contains  leaves,  flowers,  and  particularly 
seeds  of  colchicum,  which  produce  nausea,  vomiting,  colic  and  diarrhcea. 
The  colchicine  acts  particularly  on  the  kidney  and  heart,  producing 
specific  disturbance,  indicated  by  hsematuria,  polyuria,  and  cardiac  pal- 
pitation, with  lowering  of  the  body  temperature. 

Even  when  poisoning  is  not  fatal,  it  is  very  apt  to  produce  abortion. 

POISONING    BY    ANNUAL    MERCURY. 

Annual  mercury  given  in  green  fodder  is  stated  to  produce  indiges- 
tion, diarrhcea,  vesical  and  intestinal  haemorrhage,  and  early  death. 
Some  authors,  however,  deny  that  it  has  such  toxic  properties. 

POISONING    BY    BRYONY. 

In  large  doses  all  parts  of  the  bryony  plant  are  toxic — the  root,  stalk, 
and  leaves. 


POISONING    BY    COTTON    CAKE.  257 

Bryony  is  sometimes  used  as  a  purgative.  Poisoning  is  characterised 
by  nausea,  sweating,  diuresis,  frequent  action  of  the  bowels,  and,  in  grave 
cases,  by  tetaniform  convulsions  followed  by  death. 

POISONING    BY    CASTOR    OIL    CAKE. 

Causation.  Excessive  use  of  this  form  of  cake  is  the  usual  cause 
of  such  poisoning,  though  bad  quality  is  also  an  important  factor.  The 
castor  oil  beans  are  often  insufficiently  crushed  and  compressed,  so  that 
a  considerable  amount  of  oil  is  contained  in  the  cakes  as  sold ;  but  the 
most  dangerous  constituent  is  undoubtedly  the  material  known  as  ricin, 
which,  in  some  specimens  of  cake,  may  exist  in  highly  dangerous 
quantity. 

The  oil  contained  in  the  cake,  like  every  other  fatty  substance, 
favours  intestinal  peristalsis  and  the  onward  movement  of  the  digested 
food.  The  laxative  principle  excites  secretion,  and  if  the  cake  be  given 
for  considerable  periods,  the  most  serious  consequences  may  ensue. 

Cakes  prepared  from  mixed  rape  seed  and  castor  beans  act  in  a 
similar  way,  though  in  a  longer  or  shorter  time,  according  to  their  rich- 
ness in  ricin. 

The  earhest  symptom  consists  in  purgation,  which  gradually  de- 
velops into  superpurgation,  and  is  followed  by  direct  irritation  of  the 
muscous  membrane,  indicated  by  serous,  foetid,  and  sometimes  san- 
guinolent,  diarrhcea.  The  symptoms  may  appear  in  twenty-four  hours. 
They  are  usually  accompanied  by  a  rise  in  temperature  of  2°  to  3°  Fahr. 
Secretion  of  milk  ceases,  and  animals  heavy  with  young  sometimes  abort. 
In  exceptional  cases  death  follows. 

The  lesions  are  those  of  hafimorrhagic  enteritis. 

Treatment  is  principally  of  a  preventive  character.  The  cakes  should 
be  examined,  and  if  they  contain  insufficiently  crushed  seeds  or  beans 
should  be  discontinued  or  given  in  smaller  quantities.  The  proportion 
of  ricin  in  mixed  rape  and  castor  cakes  should  be  determined. 

Curative  treatment  consists  in  removing  the  cause  and  treating  the 
enteritis.  The  latter  is  best  controlled  by  giving  emollients,  diuretics, 
and  mucilaginous  drinks  prepared  from  linseed,  marsh-mallow,  barley,  etc. 

POISONING  BY  COTTON  CAKE. 

Cotton  cake  forms  a  rich  food,  which  fattens  animals  very  rapidly, 
but  given  in  excess  may  produce  true  poisoning,  and  if  prepared  from 
undecorticated  seed  may  produce  mechanical  irritation  ending  in  ob- 
struction of  the  bowel. 

The  latter  accident  occurs  only  in  the  sheep.  It  consists  in  ob- 
struction of  the  omasum  (uesophageal  gutter),  and  particularly  of   the 

B.C.  S 


258  toisoNiNG. 

abomasum,  by  the  woody  seed  covering,  the  fibres  of  which  become 
aggkitinated  and  close  the  pyloric  opening,  just  as  do  the  fragments  of 
wool  or  the  hairs  in  animals  affected  with  the  licking  habit  (pica,  de- 
praved api)etite).  The  mass  thus  formed  passes  into  the  intestine,  and 
is  apt  to  become  fixed  at  some  point  and  to  cause  death. 

In  the  ox,  as  in  the  sheep,  true  poisoning  may  result  from  the  action 
of  an  injurious  principle  which  Cornevin  discovered  in  the  seed  and 
particularly  in  the  meal.  The  relative  rarity  of  such  accidents  is 
exjDlained  by  the  composition  of  the  cakes,  wliich  are  rich  in  husks  but 
poor  in  meal. 

In  the  first  series  of  accidents  the  symptoms  resemble  those  pro- 
duced by  the  intestinal  obstructions  pecuUar  to  the  licking  disease;  in 
the  second  they  appear  about  the  eighth  to  the  fifteenth  day,  and  are 
indicated  l)y  sensitiveness  of  the  abdomen  and  by  efforts  to  pass  urine. 
The  urine  is  albuminous ;  at  a  later  stage  it  becomes  darker  in  colour, 
reddish,  and  stained  with  ha;moglobin.  The  mucous  membranes  exhibit 
a  sub-icteric  tint. 

Lesions.  The  liver  shows  interstitial  hepatitis,  consequent  on  changes 
in  the  hepatic  cells  due  to  the  poisonous  principle.  The  kidney  first 
shows  lesions  of  interstitial,  but  afterwards  of  epithelial,  nephritis ;  the 
endothelium  of  the  tubes  appears  to  be  undergoing  proliferation. 

Treatment  should  only  be  undertaken  when  the  organic  lesions 
seem  trifling,  and  suggest  the  possibility  of  cure  without  excessive 
outlay.  Under  such  circumstances  it  is  sufficient  to  remove  the  cause 
and  to  supply  proper  diet. 

• 

POISONING    BY    MOLASSES    REFUSE. 

Molasses  refuse  is  much  used  about  Paris  and  in  the  department  of 
Le  Nord  for  fattening  or  simply  for  feeding  animals.  Added  to  rough 
fodder,  even  of  poor  quality,  the  refuse  renders  it  palatable,  and  thus 
forms  an  economic  food ;  it  also  improves  the  condition  of  animals  with 
broken  wind.  Its  poverty  in  nitrogenous  materials  (the  refuse  consists 
of  GO  per  cent,  of  hydrocarbons ;  10  to  12  per  cent,  of  potash  and  soda 
salts)  renders  it  necessary  to  enrich  it  in  this  respect.  Moreover,  only 
a  limited  quantity  should  be  given.  If  given  in  larger  amounts  than 
2  to  2^  parts  per  500  parts  of  body  weight  it  may  produce  bad  effects. 
In  this  case  the  earlier  symptoms  point  to  interference  with  the  urinary 
apparatus,  the  digestive  apparatus  being  affected  later ;  both  accidents 
are  due  to  the  potash  and  soda  salts  present  in  the  refuse,  and  may 
become  so  well  marked  as  to  constitute  true  poisoning. 

The  symptoms  consist  in  abundant  diuresis,  resulting  from  the 
excess  of  potash  and  soda  salts,  and  are  followed  by  albuminuria.  Super- 
purgation  is  usually  present. 


DISEASES    PRODUCED   BY   DISTILLERY    AND    SUGAR    FACTORY   PULP. 

Lesions.  On  post-mortem  examination  one  finds  lesions  of  irritant 
gastro-enteritis,  and  of  chronic  nephritis. 

Treatment  consists  in  withdrawing  the  molasses  refuse,  and  giving 
milk,  mucilaginous  fluids,  barley  water,  and  cereals,  which  soothe  the 
kidney. 

DISEASES    PRODUCED    BY    DISTILLERY    AND    SUGAR    FACTORY    PULP. 

This  disease,  which  is  very  common  in  France  and  Germany,  results 
from  feeding  on  distillery  and  sugar  factory  residues,  consisting  for  the 
most  part  of  beet  pulp. 

In  1860  Guionnet  described  it  under  the  name  of  disease  of  the 
abomasum,  and  more  recent  work  by  Butel,  Rossignol,  and  Arloing  has 
thrown  a  great  deal  of  light  on  its  exact  nature. 

Causation.  Guionnet  attributed  the  injurious  action  of  beet  pulp, 
etc.,  to  excess  of  acidity,  due  to  the  addition  of  sulphuric  iicid  during 
manipulation  in  the  factory ;  but  it  has  since  been  shown  that  this  acidity, 
if  existing,  is  specially  due  to  various  fermentation  products,  the  results 
of  lactic,  butyric,  ai)d  acetic  fermentation,  etc. 

Rossignol  regarded  the  symptoms  as  wholly  due  .to  the  excessive 
proportion  of  water,  viz.,  90  per  cent.  ;  but  this  does  not  explain  the 
general  symptoms  of  poisoning. 

The  real  cause  is  to  be  sought  in  the  manner  of  preserving  the  pulp 
in  simple  earth  silos  or  in  cemented  silos,  where  it  undergoes  fermenta- 
tion and  putrefaction.  The  contained  liquid  is  then  extremely  toxic. 
Filtered  through  porcelain  and  injected  under  the  skin,  it  produces 
vaso-motor  and  vaso-paralytic  disorder,  identical  with  that  seen  in  acute 
forms  of  the  disease ;  in  other  cases  it  excites  abnormal  secretion,  and 
leads  to  permanent  diarrhoea  and  chronic  gastro-enteritis. 

This  liquid,  if  injected  intravenously,  may  prove  toxic  in  doses 
of  2  to  3  cubic  centimetres  per  kilogram  of  bodily  weight.  Its  in- 
jurious effect  is  due  to  toxins  secreted  by  special  bacilli,  which  were 
isolated  and  studied  by  Arloing.  The  toxicity  diminishes  as  the  pulp 
becomes  older,  and  can  be  avoided  by  adding  antiseptics  like  common 
salt,  which  prevent  fermentation.  These  experiments  of  the  Lyons 
professor  are  certainly  very  interesting,  and,  although  perhaps  not 
identical  with  what  occurs  in  practice,  sufficiently  indicate  the  way  in 
which  poisoning  occurs. 

Pathological  disturbance  only  follows  the  use  of  decomposed  pulp. 

Animals  reared  on  farms  where  distillery  and  sugar  factory  pulp  is 
regularly  given  become  accustomed  to  it,  and  are  rarely  affected.  The 
chief  sufferers  are  those  recently  imported,  or  recently  placed  on  such 
food  ;  in  them  the  disease  may  assume  either  the  acute,  nervous,  sub- 
acute, or  chronic  form. 

s  2 


260  POISONING. 

Acute  form  :    Symptoms.     This  form  is  exceptional  in  the  ox,  but 

is  more  frequent  in  the  sheep.  In  oxen  the  earlier  sjanptoms  point  to 
digestive  disturbance,  and  consist  of  dulness,  loss  of  appetite,  colic, 
sensibility  of  the  abdomen,  cessation  of  rumination  (without  tympanites), 
and  constipation.  The  excreta  are  hard,  coated,  and  blackish  in  colour, 
but  not  blood-stained. 

Diarrhoea  follows,  is  accompanied  by  aggravation  of  the  general  symp- 
toms, the  temperature  rises  to  104"*  or  106°  Fahr.  (40°  or  41°  C),  and 
exhaustion  is  pronounced.  Other,  less  characteristic,  symptoms,  such  as 
grinding  of  the  teetli  and  mastication  without  food  being  present  in 
the  mouth  may  accompany  the  above  and  arouse  fears  of  peritonitis. 
In  sheep  the  dulness  and  prostration  shown  at  first  suggest  the  existence 
of  anthrax — a  view  strengthened  by  the  fact  that  the  respiration  becomes 
very  frequent  and  the  fever  intense,  whilst  death  may  be  rapid,  and  may 
sometimes  occur  with  startling  suddenness. 

Lesions.  Bacteriological  examination,  or  even  a  naked-eye  examina- 
tion, made  immediately  after  death  enables  one  easily  to  differentiate 
between  the  two  conditions.  When  the  animals  have  died  very  rapidly — 
in  one  night — lesions  of  enteritis  alone  are  present.  More  marked  cases 
exhibit  thickening  and  intense  congestion  of  the  mucous  membrane  of 
the  abomasum,  which  may  be  of  a  deep  mahogany  colour. 

The  intestine  itself  is  affected,  and  even  though  the  glandular 
epithelium  is  little  changed,  the  intercellular  spaces  show  ecchymoses 
and  multiple  luemorrhages,  which  give  the  contents  of  the  digestive 
tract  the  appearance  of  wine  lees. 

The  abdominal  viscera  scarcely  present  any  characteristic  lesions. 
The  liver  has  the  appearance  of  having  been  boiled,  as  in  many  forms 
of  poisoning.  The  kidney  is  congested  and  blackish ;  the  spleen  only 
appears  hypertrophied  when  post-mortem  examination  has  been  delayed 
and  micro-organisms  from  the  intestine  have  invaded  the  circulatory  sys- 
tem.  After  death  the  kidneys  and  spleen  very  rapidly  undergo  softening. 

Nervous  form :  Symptoms.  Whilst  in  the  first  form  the  symptoms 
appear  especially  due  to  diastatic  ferments  present  in  the  pulp  liquid, 
in  the  nervous  form  they  appear  rather  to  result  from  the  convulsing 
and  paralysing  action  of  ptomaines. 

The  ox  seems  more  particularly  susceptible  to  the  action  of  the  latter. 
It  shows  symptoms  resembling  those  of  horses  sufferiiig  from  a  severe 
abdominal  form  of  influenza :  profound  depression,  mahogany- coloured 
conjunctiva,  lachrymation,  infiltration  of  the  cornea,  high  temperature 
(104°  to  106°  Fahr.— 41°  to  41-5°  C),  strong  action  of  the  heart,  but 
small  pulse.  The  cerebral  symptoms  are  especially  marked.  The  animal 
suffers  from  vertigo,  and  when  excited,  or  when  attempts  are  made  to 
administer   medicine,  it   thrusts  its  head   against   the  wall,  as  though 


DISEASES   PRODUCED   BY   DISTILLERY   AND   SUGAR   FACTORY    PULP.      261 

suffering  from  a  cerebral  tumour.     It  also  shows  hyperaesthesia,  slight 
colic,  and  sensitiveness  of  the  abdomen. 

In  sheep  the  symptoms  consist  in  alternate  extreme  depression  and 
extreme  excitability. 

In  both  species  the  termination  is  always  rapid :  death  occurs  in  a 
few^  days. 

The  abdominal  lesions  are  identical  with  those  of  the  acute  form. 
They  consist  in  gastro-enteritis,  or,  rather,  intense  congestion  of  the 
abomasum  and  intestine,  with  extravasation  of  blood  around  the  acini 
of  the  glands  and  beneath  the  mucous  membrane,  etc.,  and  in  more  or 
less  marked  desquamation  of  epithelium. 

The  annexed  organs  sometimes  present  secondary  changes :  in  the 
nervous  centres  the  lesions  are  more  marked ;  the  meninges  are  con- 
gested, in  some  cases  inflamed,  and  cerebro-spinal  fluid  is  present  in 
increased  quantity. 

Subacute  or  Chronic  form  :  Symptoms.  This  form  is  equally 
frequent  in  the  ox  and  sheep  ;  it  develops  insidiously,  and  for  a  time 
may  escape  detection. 

The  symptoms  are  those  of  slight  gastro-enteritis  without  tympa- 
nites; but  this  condition  is  succeeded  by  serous,  foetid,  uncontrollable 
diarrhoea,  which  weakens  the  animal  and  causes  death  from  excessive 
wasting  and  hydr?emia. 

The  sensitiveness  of  the  entire  right  side  of  the  abdomen,  the  special 
diarrhoea,  the  cardiac  disturbance,  and  the  widely-distributed  oedema, 
usually  suffice  to  prevent  confusion  with  the  ordinary  forms  of  gastro- 
enteritis. In  sheep  the  diarrhoea  is  blackish,  sometimes  blood-stained, 
and  is  accompanied  by  a  sub-icteric  or  icteric  tint  of  the  mucous  mem- 
branes, of  the  skin,  and  of  all  the  tissues.  The  intensity  of  coloration 
affords  a  guide  to  the  rapidity  of  development  of  the  disease.  The  urine 
is  also  bile-stained,  and  there  appears  to  be  an  exchange  of  functions 
between  the  two  great  depurative  organs,  the  liver  and  kidney.  The 
urine  may  become  sanguinolent,  because  it  contains  either  unchanged 
blood  or  simply  dissolved  haemoglobin. 

The  lesions  are  similar  to  those  previously  described,  but  with 
modifications  of  intensity.  When  diarrhoea  has  been  marked  and  per- 
sistent, the  digestive  mucous  membrane  is  hardened,  indurated,  and 
appears  as  though  tanned.  This  is  due  to  chronic  inflammation, 
probably  to  the  gastro-enteritis  with  which  the  condition  begins.  The 
liver  appears  as  if  cooked ;  the  fat,  the  majority  of  the  tissues,  and 
especially  the  conjunctiva,  exhibit  a  light  yellow  tint,  pointing  to  hepatic 
disturbance. 

The  diagnosis  is  generally  easy  in  all  three  forms,  provided  that 
the  food  be  examined. 


262  POISONING. 

The  prognosis  varies ;  the  acute  and  nervous  forms  are  usually 
fatal.     But  Avlien  the  disease  develops  slowly,  recovery  may  occur. 

Pathogeny.  Practical  observation  and  laboratory  researches  show- 
that  the  above  conditions  result  from  poisoning.  Histological  examina- 
tion of  livers  from  sheep  which  have  died  rapidly  shows  complete 
degeneration  of  the  hepatic  cells,  which  become  incapable  of  per- 
forming their  function.  The  biliary  acids,  no  longer  being  withdrawn 
from  the  circulating  blood,  produce  general  intoxication,  destruction  of 
the  blood  corpuscles,  and  the  appearance  of  hfemapha-ic  icterus  and 
luemoglobinuria. 

Treatment.  Being  convinced  that  acidity  alone  caused  this  disease, 
the  older  practitioners  suggested  the  administration  of  salines.  In 
reality  it  is  necessary  to  check  fermentation.  Drainage  of  the  silos  in 
which  beet  pulp  is  stored  is  often  sufficient  for  this  purjDose ;  but  if  badly 
arranged,  drainage  rather  assists  the  growth  of  moulds  and  various 
organisms  in  the  mass,  which  affords  a  medium  favourable  to  their 
multiplication.  Complete  desiccation  would  undoubtedly  give  much 
better  results,  but  cannot  economically  be  effected.  The  best  practical 
measure  consists  in  storing  the  pulp  in  special  silos,  divided  into 
compartments  by  lattice  work  partitions.  The  escape  of  liquid  is 
facilitated  by  forming  the  floors  of  the  silo  with  a  sufficient  slope. 
Preservation,  however,  is  not  perfect,  and  some  compartments  are 
always  found  damaged.  Excessive  fermentation  can  be  checked  by 
adding  ordinary  salt  to  the  pulp  in  the  proportion  of  "2  per  cent. 

Curative  treatment  com})rises  restricted  diet  for  several  days,  and  the 
administration  of  milk,  carbonate  of  soda,  and  stimulants,  which  favour 
excretion  of  the  toxins.  Some  patients  may  be  saved  by  subcutaneous 
injections  of  large  quantities  of  normal  salt  solution.  When  poisoning 
is  pronounced,  and  the  viscera  are  clearly  injured,  it  is  more  economical 
to  slaughter  the  animals,  provided  that  the  icterus  does  not  render  the 
flesh  useless  for  sale. 


CHAPTER     VIII. 

PARASITES    OF    THE    DIGESTIVE    APPARATUS. 

Parasites  of  the  digestive  apparatus  are  extremely  common  in 
ruminants,  some,  like  the  infusoria  of  the  rumen,  being  of  no  importance, 
others,  on  the  contrary,  appearing  to  play  a  predominating  part  in  the 
development  of  certain  forms  of  anaemia  and  serious  wasting  diseases, 
such  as  the  various  forms  of  gastro-intestinal  strongylosis,  coccidial 
enteritis,  etc. 

GASTROJNTESTINAL    STRONGYLOSIS    IN    SHEEP. 

PARASITIC     CiASTRO-ENTERITIS.       OVINE    PASTEURELLOSIS. 

Verminous  diseases  of  the  abomasum  are  common  in  the  sheep  and 
goat,  but  (in  France  at  least)  appear  rare  in  the  ox. 

Causation.  Gastro-intestinal  strongylosis  is  produced  by  various 
parasites  of  the  genus  Strongylus,  such  as  Strongylus  contortus, 
Stronfjijlus  conroluttis,  Sfroiuii/his  instahilis,  Strongylus  circumcinctus, 
Strongijlus  ^fiUcoUs,  which  occur  not  only  in  the  abomasum,  but  also 
in  the  small  portions  of  the  first  intestine,  sometimes  in  very  large 
numbers. 

The  first  is  a  threadlilce  worm,  pointed  at  both  extremities,  and  from 
^  to  1  inch  in  length.  It  exhibits  a  red  tint,  which  zoologists  refer  to  the 
presence  of  blood  in  its  digestive  apparatus,  derived  from  the  host's  in- 
testinal mucous  membrane.  Some  doubt  has  been  thrown  on  the  nature 
of  this  coloration,  however ;  and  certain  Italian  authors,  in  common 
with  Lignieres,  have  declared  it  due  to  a  certain  red  pigment  developed 
in  the  tissues  of  the  parasite,  the  spectroscopic  reaction  of  which  differs 
from  that  of  haemoglobin. 

The  strongyles  are  said  not  to  penetrate  the  mucous  membrane,  but 
simply  live  on  the  intestinal  contents.  This  may  be  true  of  certain 
varieties,  but  it  is  none  the  less  certain  that  others  penetrate  the  mucous 
membrane  deeply,  even  to  the  extent  of  becoming  half-embedded  in  it. 
Particularly  is  this  the  case  with  Strongylus  circuujcinctus,  found  in  the 
epizooty  which  occurred  at  Grignon,  and  also  found  by  Moussu  in  grave 
epizootics  which  he  has  from  time  to  time  investigated. 

According  to  Lignieres  this  gastro-intestinal  strongylosis  only  plays  a 


26-i  PARASITES    OF   THE   DIGESTIVE   APPARATUS. 

trifling  part  in  the  development  of  the  ahove-raentioned  disease,  which 
he  dechires  to  be  due  to  infection  with  a  cocco-hacillus  of  the  Pas- 
teurella  group,  the  development  of  which  alone,  he  states,  explains 
all  the  symptoms. 

In  France  the  disease  now  under  consideration  has  never  extended 
be3'ond  limited  regions,  hut  in  A^rgentina,  where  Lignieres  carried  out  his 
investigations,  it  is  said  to  be  very  fatal.  Lignieres  bases  his  opinion  on 
the  following  facts : — 

Firstly,  that  experimental  verminous  infection  of  young  animals  does 
not  produce  either  anaemia  or  cachexia. 

Secondly,  that  animals  in  excellent  condition  may  prove  to  be  infested 
with  large  numbers  of  parasites. 

Thirdly,  that  animals  which  have  succumbed  to  this  disease,  hitherto 
regarded  as  verminous,  sometimes  prove  to  harbour  few  or  no  parasites. 

Fourthly,  that  this  grave  and  fatal  disease,  and  the  symptoms  by 
which  it  is  clinically  recognised,  can  be  produced  with  cultures  of  the 
cocco-bacillus,  which  he  has  isolated. 

These  statements  are  very  precise,  but  Mossu  declares  that  he  has 
never  yet  been  convinced  of  the  reliability  of  the  last  statement  referring 
to  experimental  transmission,  any  more  than  of  the  data  regarding 
alleged  protective  vaccination. 

The  symptoms  of  gastro-intestinal  strongylosis  or  ovine  pasteurel- 
losis  point  to  a  progressive  pernicious  annemia  of  chronic  or  sul)acute 
form.     Rapidly  progressive  cases  are  exceptional. 

In  France  the  form  seen  is  almost  invariably  chronic.  The  animals 
appear  dull,  sluggish,  and  feeble ;  they  lose  appetite,  waste,  become 
anaemic,  then  cachectic,  and,  after  several  months,  die  of  exhaustion 
and  wasting,  after  having  shown  diarrhoea  during  the  later  stages. 

The  ffeces  are  pasty,  and  exhale  a  very  marked  putrefactive  odour. 
There  is  little  room  to  doubt  that  auto-intoxication  from  resorption  of 
intestinal  products  is  continually  going  on. 

The  animal's  general  appearance  is  bad,  the  ears  are  pendant,  the 
wool  is  dry  and  dull,  and  can  be  removed  in  handfuls  Ijy  the  slightest 
pull.  There  are  no  other  external  symptoms,  and  the  diagnosis  can  only 
be  arrived  at  by  discovering  the  eggs  of  the  parasite  in  the  faeces.    ■ 

Lesions.  Post-mortem  examination  reveals  all  the  general  lesions 
of  advanced  cachexia  and  of  gastro-enteritis  of  varying  intensity.  The 
abomasum  and  first  portions  of  the  small  intestine  usually  contain  a 
consideral)le  number  of  strongyles  ;  tfieniae  are  often  present  in  the 
intestine,  and  Moussu  declares  that  he  has  always  found  a  certain 
number  of  hooked  worms  and  oesophagostomes. 

The  peritoneal,  pleuritic,  and  pericardial  exudates  common  in  most 
wasting  conditions  are  always  present,  but  the  quantity  of  exudate  in 


GASTRO-INTESTINAL    STRONGYLOSIS    IN    SHEEP. 


265 


each  cavity  varies  within  wide  Hmits.  The  Kquid  may  even  resemble 
that  due  to  inflammation  or  infection  ;  sometimes  it  is  light  pink  or 
red  in  colour. 

Pulmonary  lesions  usually  exist.  Moussu  has  almost  always  found 
gastric  strongylosis  associated  with  pulmonary  or  tracheo-bronchic 
strongylosis,  but  Lignieres  asserts  that  the  Argentine  cases  showed 
nodules  of  hepatisation  which  had  nothing  to  do  with  the  pulmonary 
strongylosis,  and  which  appeared  to  result  from  areas  of  pneumonia 
produced  by  the  si)ecific  cocco-bacillus  and  other  organisms.  He  has 
even  found  abscesses  and  cavernous  spaces  in  the  lung. 

Pathogeny.  According  to  Lignieres  the  specific  agent  of  pernicious 
anpemia  is  a  cocco-bacillus  which  stains  well  with  fuchsin,  violet,  blue, 
safranin,  etc.,  but  does  not 
take  Gram,  and  which  in 
cultures  assumes  either 
the  strepto-bacillary  form 
or  occurs  in  barrel- shaped 
masses.  It  grows  in  simple 
bouillon  at  dS^  C,  but 
better  still  in  peptonised 
bouillon,  which  turns  tur- 
bid for  live  or  six  days, 
afterwards  becoming  lim- 
pid in  consequence  of  the 
organisms  falling  to  the 
bottom  of  the  vessel.  It 
does  not  coagulate  milk. 
On  agar  the  culture  is 
thin,  bluish,  shows  an 
iridescent  reflection,  and 
when  old  appears  whitish. 
Grown  on  gelatine,  the  appearances  are  similar — the  gelatine  is  not 
liquefied  ;    on  serum  the  pellicle  is  scarcely  visible. 

The  organism  is  said  to  be  pathogenic  for  guinea-pigs,  ral)bits,  dogs, 
and,  of  course,  for  sheep.  Moussu,  however,  does  not  consider  that  the 
reported  cases  of  transmission  through  the  blood  stream  or  by  subcu- 
taneous injection  are  really  convincing  or  characteristic.  He  does  not 
question  the  fact  that  Lignieres  discovered  a  special  pathogenic  agent  in 
all  cases  and  in  all  his  patients;  but  what  appears  to  him  debatable 
is  the  exclusive  part  which  Lignieres  attributes  to  that  agent. 

The  fact  that  in  Argentina,  just  as  in  France,  strongyles  have  always 
been  discovered  in  epizootics  of  this  nature  of  itself  constitutes  some- 
thing ;   and  causes  the  second  fact,  that  it  has  never  yet  been  proved 


Vui.  114. 


A\-astin-  .In.,  t.)  ■ 
strongylosis. 


2C6  PARASITES    OF    THE    DIGESTIVE    APPARATUS, 

that  any  heavy  moi'tahty  occurred  in  the  ahsence  of  parasitic  infestation, 
to  assume  considerable  importance.  Moussu  regards  these  two  facts  as 
the  greatest  obstacles  to  Lignieres'  theory.  He  states  that  in  his  view 
the  verminous  affection  is  the  essential,  primordial  and  primitive 
affection,  and  that  microbic  infection  is  only  secondar}^  and  an  almost 
inevitable  result  of  grave  verminous  infestation. 

It  is  quite  certainly  wrong  to  think  that  verminous  affections  may 
continue  with  scarcely  any  injury  to  the  animal,  especially  when  such  a 
belief  is  based  on  observation  of  a  few  parasites  which  are  not  of  a  pre- 
datory character.  In  most  cases  of  the  kind  now  under  consideration, 
the  various  parasites  found  {Stronf/ijlus  circuiiicinctus  and  fiUcoUs,  Anchy- 
lostomes,  etc.)  cause  more  or  less  grave  lesions. 

These  intestinal  wounds  facilitate  the  infection  to  which  the  fatal 
course  of  the  disease  is  due.  The  disease,  then,  is  not  a  special  unvarying 
infection,  but  consists  of  multiple  superposed  infections. 

It  is  wrong  to  l)elieve  and  to  teach  that  the  parasitic  disease  is  of 
no  importance,  and  Moussu  declares  his  belief  that  the  proposed  vacci- 
nations will  prove  unavailing.  He  is  of  opinion,  on  the  other  hand, 
that  when  the  parasitic  invasion  can  be  overcome  the  mortality  will 
be  checked,  and  only  those  animals  which  are  already  suffering  from 
severe  infections  will  succumb.  Is  not  this  precisely  what  has  been 
observed  in  human  pathology  regarding  miners'  anfemia  or  miners' 
worm  disease  (anchylostomiasis)  ? 

The  diagnosis  presents  no  difficulty  for 'those  who  liave  had  a  little 
practice  with  the  microscope,  since  the  presence  of  eggs  of  the  parasite 
can  always  be  detected  in  the  fteces  in  cases  where  external  signs  have 
given  rise  to  suspicion  of  gastro-entestinal  strongylosis. 

The  macroscopic  diagnosis  on  post-mortem  examination  is  not  so  easy 
as  might  be  supposed,  and  when  very  small  varieties  are  in  question  it  is 
sometimes  necessary  to  examine  the  mucous  membrane  of  the  abomasum 
or  intestine  very  carefully  in  order  to  discover  the  parasite. 

The  prognosis  is  grave,  because  before  attention  has  been  drawn  to 
many  patients,  the  entire  herd  may  be  more  or  less  infested.  It  is  also 
grave  because  the  pastures  are  infested  with  eggs  or  embryos,  and  the 
power  of  increase  of  these  parasites  is  enormous. 

Treatment.  The  earliest  and  most  energetic  means  should  be 
adopted  in  all  cases.      Treatment  comprises  : — 

Drainage  of  swampy  pastures. 

Dressing  of  the  pastures  with  chemical  manures,  preferably  with 
iron  sulphate,  at  the  rate  of  40  to  80  lbs.  per  acre. 

Disinfection  of  manure  to  destroy  the  contained  eggs  or  embryos. 

The  use  of  chalk,  iron  sulphate,  various  acids,  etc. 

As  regards  curative  treatment,  the  diseased  animals  should  be  grouped 


LUMBKICOSIS    OF   CALVES.  267 

and  isolated  as  far  as  possible,  and  should  receive  doses  of  the  following 
vermifuge  :— 

Powdered  areca  nnt   .  .  .  .  .  ,  .  .  .  .  .  .        2  ounces. 

Arsenic  .  .  .  .  .  .  .  .  .  .  .  .  .      30  grains. 

The  above  is  sufficient  for  ten  animals,  and  a  dose  should  be  given 
daily  for  a  period  of  six  days  in  a  small  quantity  of  bran.  Treatment 
is  completed  by  abundant  nourishment,  and  by  distributing  about  the 
pastures  pieces  of  rock-salt  suitably  protected.. 

Many  other  vermicides  or  vermifuges  have  been  suggested,  but  are 
less  easy  to  use.  They  comprise  essence  of  turpentine,  mixtures  of 
oil  with  essence  of  turpentine  and  benzine,  picrate  of  potash  in  doses 
of  7  to  20  grains  per  day,  ethereal  extract  of  male  fern,  etc. 

LUMBRICOSIS    OF    CALVES. 

Following  the  example  of  human  medicine,  we  apply  the  term 
"  lumbricosis "  to  a  disease  caused  by  ascarides  in  calves,  although 
Neumann  separates  the  ascarides  of  calves  from  the  lumbricoid  ascarides 
with  which  they  are  usually  confused  in  current  practice. 

Causation.  The  disease  is  exclusively  due  to  infestation  with  embryos 
of  the  parasite,  which  in  young  calves  afterwards  develop  in  the  first 
portions  of  the  intestine  and  in  the  abomasum,  interfering  with  secretion, 
and  producing  mechanical  disturbance,  colic,  and  digestive  irregularity, 
eventually  followed  by  marked  loss  of  condition.  Death  may  even  follow, 
either  from  rupture  of  the  pylorus  or  duodenum,  or  from  secondary 
septicaemia  of  intestinal  origin,  due  to  the  parasites  burrowing  into  the 
mucous  membrane  and  facilitating  infection.  In  adults  of  all  species 
lumbricosis  is  rare.  It  occurs  principally  in  young  animals  from  the 
time  of  weaning  up  to  the  age  of  eighteen  months  or  two  years. 

The  diagnosis  cannot  usually  be  formed  until  the  parasites  are 
found  in  the  ffeces,  but  microscopic  examination  sometimes  reveals  the 
presence  of  the  eggs,  and  thus  excites  suspicion. 

Provided  the  condition  is  diagnosed  early,  the  prognosis  is  not 
grave ;  but  when  patients  have  become  exhausted  and  anfemic  they  re- 
quire a  long  time  to  recover,  even  when  freed  from  parasites. 

Treatment.  Guittard  recommends  empyreumatic  oil  as  very  effica- 
cious, and  gives  it  in  doses  of  2^  to  3  drachms  diluted  with  ordinary  oil, 
or  emulsified  with  any  kind  of  mucilage. 

Calomel  gives  good  results,  and  may  be  administered  in  doses  of  15  to 
60  grains,  according  to  the  animal's  age  and  size. 

Powdered  areca  nut  would  probably  be  easier  to  administer  with  the 
food.  Oil  of  turpentine  is  given  mixed  with  ordinary  oil,  but  its  action 
is  less  certain. 


268  PARASITES    OF   THE    DIGESTIVE    APPARATUS. 


STRONGYLOSIS    OF    THE    ABOMASUM    IN    THE    OX. 

Altboufi;h  well  studied  by  Stadelmann  and  Ostertag  in  Germany,  and 
by  Stiles  in  x\merica,  this  disease  has  not  3'et  been  regarded  in  France  as 
giving  rise  to  accidents. 

It  is  produced  by  the  Strongyhis  convolutus  rel  Ostertarii,  which 
becomes  embedded  under  the  epithelium  of  the  mucous  membrane  and 
causes  the  formation  of  small  nodules,  the  size  of  a  pin's  head  or  lentil, 
which  can  be  detected  on  palpation.  The  cavity  thus  formed  beneath 
the  epithelium  communicates  with  the  gastric  cavity  by  a  little  orifice, 
through  which  the  cephalic  end  of  the  parasite  passes. 

PARASITIC    G ASTRO-ENTERITIS,   DIARRHOEA,   AND    ANAEMIA 
IN    CATTLE,    SHEEP    AND    LAMBS. 

A  disease  characterised  by  anaemia  with  wasting  and  diarrhoea  is 
sometimes  produced  in  cattle  by  the  presence  in  the  fourth  stomach 
of  small  strongyles  varying  in  size  between  3  and  9  millimetres  in  length, 
according  to  the  variety  encountered.  One  variety  of  the  smaller  size 
has  been  named  by  McFadyean  Strongi/hts  graciUs.  Penberthy,  who 
described  the  disease  in  the  Jour,  of  Comp.  Path,  and  Therap.  for  1894, 
p.  249,  states  that  in  certain  cases  he  also  found  the  Strongj/lus  ventri- 
cosKS,  the  Tricocephaliis  qffiinis,  and  minute  straight  worms  about  -^^  of 
an  inch  long,  which  he  regarded  as  anguillulfe.  Neumann  declares 
that  pernicious  anaemia  with  catarrh  of  the  abomasum  in  young  animals 
is  due  to  Strongylus  conrolatiis. 

The  symptoms  comprise  anaemia,  wasting,  and  diarrhoea  of  varying 
severity.  In  acute  cases,  which  are  common  between  the  ages  of  six 
months  and  two  years,  husk  is  sometimes  (accidentally)  present.  The 
disease  is  rarest  in  summer.  Certain  animals  lose  flesh  rapidly,  though 
appetite  is  retained.  Acute  foetid  watery  diarrhoea  follows.  The  animal 
shows  tenesmus,  appears  dejected,  and  has  a  temperature  of  103°  to 
105°  Fahr.  The  mucous  membranes  become  pale,  the  pulse  small  and 
weak,  the  appetite  capricious,  the  eyes  sunken,  belly  tucked  up,  coat  harsh 
and  dry  and  hide  tight.  Wasting  is  rapid.  The  animals  are  listless,  and 
often  lie  down  for  long  periods.    Death  occurs  from  exhaustion. 

The  parasite.  Scrapings  from  the  abomasum  and  intestine  when 
diluted  with  water  and  viewed  under  a  lens  show  minute  bodies  re- 
sembling short,  fine  hairs.  When  isolated  these  are  easily  visible  with 
the  naked  eye.  In  situ  they  appear  to  be  lying  on  the  mucous  mem- 
brane, sometimes  with  the  head  fixed  in  the  latter.  They  vary  in  length  • 
from  7^^3  to  2*^-  of  an  inch,  and  are  brownish  in  colour.  For  a  detailed 
description  see  Penberthy  loc.  cit.     McFadj'ean  (Jour,  of  Comp.  Path,  and 


PARASITIC   GASTRO-ENTERITIS,    ETC.,    IN    CATTLE,    SHEEP   AND    LAMBS.       269 


Therap.  for  1896,  p.  314)  also  gives  a  very  full  description,  illustrated  by 
plates,  of  the  two  species  of  strongyles  which  he  regards  as  the  cause 
of  gastritis  in  cattle  in  England. 

The  lesions  are  those  of  wasting  diseases.  The  first  three  gastric 
compartments  may  be  thin,  but  usually  show  no  abnormality.  The 
mucous  membrane  of  the  abomasum  shows  evidences  of  catarrh,  is 
sometimes  covered  with  a  loose  croupous  material,  or  is  denuded  of  its 
epithelium  and  even  extensively  destroyed.  In  acute  cases  it  is  more 
or  less  deeply  reddened  over  spots  or  extensive  patches.  Occasionally 
it  appears  jelly-like,  owing  to  effusion  into  its  substance.  Except  for 
the  catarrhal  condition 
the  small  intestines  may 
be  healthy,  but  the  large, 
especially  the  colon  and 
ciecum,  show  lesions  simi- 
lar to,  l)ut  more  pro- 
nounced than,  those  of 
the  abomasum. 

The  treatment  com- 
prises administration  of 
the  usual  vermifuges,  of 
which  Penberthy  prefers 
turpentine.  The  diet 
should  be  nutritious  and 
easily  digestible.  Among 
drugs,  non  -  irritant  iron 
salts,  cod  liver  oil,  bitter 
vegetable  tonics  and  com- 
mon salt  are  recom- 
mended. The  animals  should  be  housed  and  kept  warm  ;  the  litter, 
containing  parasites,  should  be  destroyed.  The  pastures  may  be  dressed 
with  salt  and  lime ;  those  worst  infected  should  be  ploughed.  An  un- 
infected water  supply  is  essential- 
Parasitic  Gastro-enteritis  in  Sheep  and  Lambs.  A  disease  in  seven 
to  eight  months  old  lambs,  closely  resembling  the  above,  was  described 
by  McEadyean  in  the  Jour,  of  Comp.  Path,  and  Therap.  for  1897,  p.  48. 
Sheep  over  one  year  old  w-ere  not  affected. 

The  symptoms  comprised  diarrhoea,  rapid  wasting,  impaired  appetite, 
thirst,  a  tendency  to  lick  and  swallow  sand  or  earth,  dulness,  and  con- 
tinued fever  (105°  to  108°  Eahr.).  There  was  no  evidence  of  acute  pain 
or  of  marked  cough. 

Duration.  The  disease  sometimes  proved  fatal  in  one  or  two  days, 
but  sometimes  extended  over   several   days  or  weeks.     The   mortality 


Fig.  115. — Caudal  extreiuitj-  of  luale  Strojif/ijln.H  cer- 
vicoritis.    (Block  kindly  lent  by  Prof.  McFadyean. 


270 


PARASITES   OF   THE    DIGESTIVE   APPARATUS. 


varied   from    10   to    20   per   cent.,  but   in   many  cases  almost  all  the 
members  of  a  flock  exhibited  diarrhoea  and  loss  of  condition. 

The  cause  appeared  to  be  the  presence  of  small  nematode  worms  in 
the  fourth  stomach,  which  generally  exhibited  gastritis  with  inflammatory 
congestion  of  the  mucous  membrane,  though  in  a  considerable  number 
of  cases  the  lining  membrane  of  the  stomach  was  markedly  ansemic.  In 
a  large  number  of  cases  the  irritation  of  the  mucous  membrane  was 
continued  into  the  duodenum,  but  as  a  rule  the  remainder  of  the  small 
intestine  was  not  inflamed. 

The  worms  named  by  McFadyean  Stronf/ijlus  ccrvicornis  are  from  10 

to  12  mm.  in  length,  so  that  although  not  of  mTcroscopic  dimensions 

they  cannot  be  seen  when  suspended  in  the  stomach  contents.     They 

are  readily  detected  in  microscopical  preparations  under  a  low  power. 

The  treatment  is  similar  to  that  of  gastro-enteritis  in  cattle,  but  chief 

attention  should  be  directed  to 
prophylaxis. 

*  *  *  * 

A  verminous  disease,  closely 
simulating  the  above,  and 
affecting  cattle,  sheep,  and 
goats  in  Texas,  is  described 
by  Ch.  Wardell  Stiles  in  the 
Annual  Eeport  of  the  United 
States  Department  of  Agricul- 
ture for  1900,  p.  356.  The 
disease  was  of  mixed  character, 
and  consisted  in  various  de- 
grees of  verminous  gastritis, 
verminous  enteritis,  and  ver- 
minous bronchitis.  In  the 
stomach  were  found  the  common  twisted  wireworm  {Stroiigi/hts  contortus) 
and  Ostertag's  encysted  wireworm  {Stronr/yJiis  Ostertagi).  It  appeared  to 
be  present  in  every  calf,  steer  and  cow  examined  (post-mortem),  and  was 
undoubtedly  the  chief  agent  in  causing  death.  The  sheep  and  goats 
were  very  similarly  aflected.  In  the  bowel  of  cattle  were  found  the 
hookworm  {Uiicinana  radiata),  nodular  disease  worm  {(Esophagostoma 
(■ohiiiihidiium)  :  in  that  of  sheep  the  hookworm  {Uncinaria  cernua)  and 
nodular  disease  worm  {(Eso})h  ago  stoma  cohimhiaiim)i),  and  the  fringed 
tapeworm  {TJiysanosovia  actiiiioidcs).  In  the  lungs  of  the  cattle  Stron- 
gylits  micrnrus  (the  small-tailed  lungworm),  and  of  sheep  the  thread- 
worm strongyle  {Stwiigijliis  filaria)  were  detected. 

Treatment.  Sulphate  of  copper,  gasoline  and  coal-tar  creosote 
were  tried,  but  the  best  results  were  obtained  from  doses  of  30  grains 


Fig.  116.  —  Caudal  extremity  of  male  Stroii 
gylus  confoiiiis.  (Block  kindly  lent  by  Prof 
McFadyean.) 


Intestinal  coccidiosis  of  calves  and  lambs.  271 

(for  a  lamb)  up  to  100  grains  (for  a  two-year-old  sheep)  of  thymol  in 
1  per  cent,  coal-tar  creosote  solution. 

INTESTINAL  COCCIDIOSIS  OF  CALVES  AND  LAMBS  (PSORO- 
SPERMOSIS, H/EMORRHAGIC  ENTERITIS,  BLOODY  FLUX, 
DYSENTERY,    ETC.). 

History.  This  disease  is  very  common  in  the  Avalon  and  surrounding 
districts,  sometimes  assumes  the  characteristics  of  a  true  epizootic,  and 
affects  young  bovine  animals  between  the  ages  of  six  months  and  two 
years,  but  is  commonest  and  most  contagious  in  animals  of  from  ten  to 
eighteen  months  old. 

It  attacks  animals  in  good  or  bad  condition,  without  distinction  of 
breed  or  species.  It  begins  towards  the  end  of  July,  attains  its  maximum 
development  towards  the  end  of  August  and  September,  and  dis- 
appears in  October,  though  occasionally  it  continues  until  November. 
In  exceptional  cases  Degoix  has  seen  it  during  January  and  February  in 
animals  which  had  returned  from  the  fields  to  the  byres  about  the  end 
of  November.  It  develops  earlier  than  verminous  bronchitis,  in  con- 
junction with  which,  however,  it  often  occurs.  It  is  commonest  in  warm, 
moist,  rainy  years,  and  amongst  animals  pastured  on  swampy  ground 
containing  numerous  springs  and  streams.  Year  after  year  it  attacks 
animals  occupying  particular  pastures  in  summer.  The  soil  of  these 
pastures  is  undoubtedly  infested  with  the  germs  of  the  disease,  just  as 
in  places  the  soil  is  infested  with  anthrax  bacilli.  The  appearance  of 
symptoms  is  preceded  by  an  incubation  period  of  one  or  two  months. 
The  length  of  this  incubation  period  is  fixed  by  the  observations  which 
Degoix  has  made  during  the  past  twenty  years,  and  depends  on  the  time 
which  elapses  between  the  animals  being  turned  into  infected  pastures 
and  the  appearance  of  the  preliminary  symptoms. 

Symptoms.  The  disease  commences  with  liquid,  serous,  fcetid, 
greenish-black  diarrhcea,  the  material  being  voided  without  special  strain- 
ing and  the  animals  losing  neither  their  spirits  nor  appetite.  Fever  can 
scarcely  be  detected,  the  temperature  ranging  between  38°  and  39°  C. 
On  the  second  or  third  day  the  diarrhoea  changes  in  character.  Though 
it  always  remains  fcetid,  it  now  becomes  mucous,  reddish-black,  or 
sanguinolent,  and  contains  more  or  less  frequent  blood  clots  of  varying 
size. 

The  passage  of  this  material  causes  violent  straining,  which  becomes 
more  and  more  common,  and  is  accompanied  by  very  pronounced  rectal 
tenesmus.  The  animals  stand  with  their  backs  arched  for  one  or  two 
minutes,  sometimes  longer,  and  the  liquid  escapes  in  large  quantities, 
soiling  the  quarters  and  hocks.     The  animals  are  dull,  show  a  certain 


272  PARASITES    OF    THE    DlGPISTIVE    APPARATUS. 

degree  of  colic,  and  frequently  grind  the  teeth.  Appetite  is  lost,  thirst  is 
severe,  and  rumination  ceases.  Wasting  makes  rapid  strides,  the  coat 
stares,  the  animals  have  difiticulty  in  standing  on  account  of  their  weak- 
ness, fever  sets  in,  and  the  temperature  rises  to  40°  C.  This  condition 
may  last  from  five  to  ten  days  and  terminate  either  in  recovery  or  death. 
Kecovery  is  frequently  rapid  in  animals  which  have  continued  to  eat,  and 
in  which  the  acute  period  has  heen  of  short  duration — five  to  seven  days 
at  most.  On  the  other  hand,  it  is  slow  if  the  appetite  has  disappeared 
and  the  acute  period  has  heen  prolonged  beyond  ten  days. 

The  diarrhoea,  which  has  lost  its  sanguinolent  character  towards  the 
sixth  or  eighth  day,  may  continue  for  somewhat  longer.  The  attacks  of 
straining  become  rare,  and  cease  between  the  tenth  and  fifteenth  days. 
The  appetite  remains  capricious  for  a  long  time. 

Convalescence  is  marked  by  alternate  improvement  and  retrogression. 
The  animals  are  weak,  and  only  recover  quickly  under  energetic  treatment 
and  forced  feeding  with  concentrated  digestible  foods  like  milk,  soup, 
cooked  grain,  etc.,  administered  for  three  weeks  or  more. 

Death  may  occur  towards  the  tenth  or  fifteenth  day  from  exhaustion. 
The  patients  become  very  anaemic  and  thin,  the  eyes  are  withdrawn  into 
the  orbits,  and  the  animals  aj^pear  indifferent  to  what  goes  on  about 
them.  They  still  groan  feebly,  occasionally  grind  the  teeth,  and  lie  con- 
tinually on  the  chest  with  the  head  extended.  The  body  temperature 
falls  and  death  follows. 

In  well-bred  animals  in  good  condition  the  disease  sometimes  assumes 
a  much  graver  and  more  rapidly  progressive  form,  with  peracute  symp- 
toms, and  makes  as  many,  if  not  more,  victims  than  that  previously 
described. 

The  process  is  as  follows :  After  suffering  for  a  day  from  serous 
diarrhoea,  to  which  the  owners  pay  little  attention,  the  animals  show 
sanguinolent  diarrhoea  and  pass  blood  clots.  This  is  almost  immediately 
followed  by  very  violent  convulsive  attacks — true  eclampsia.  The 
animals  are  then  unable  to  stand,  lie  on  the  side  with  the  head 
outstretched  and  resting  on  the  ground,  the  eyes  withdrawn  into  the 
sockets  and  often  showing  pirouetting  movements  (nystagnuis),  the  neck 
drawn  upwards  and  backwards  (opisthotonos),  and  the  limbs  rigidly 
extended.  From  time  to  time  the  wdiole  body  is  shaken  by  extremely 
violent  convulsive  movements. 

This  condition,  which  is  sometimes  preceded  by  weakness  of  the  hind 
quarters  and  symptoms  of  locomotor  ataxia  and  inco-ordination,  may  con- 
tinue from  six  Lo  thirty-six  hours ;  in  nine  cases  out  of  ten  it  terminates 
in  death. 

Causation.  On  microscopic  examination  of  the  serous  dejections 
one  finds  distributed  throughout  the  liquid  mass  very  small  numbers  of 


INTESTINAL   COCCIDIOSIS   OF   CALVES    AND    LAMBS.  273 

ovoid  corpuscles  having  a  double  outline,  and  contents  of  varied 
appearance ;  these  are  the  coccidia. 

When  the  diarrhoea  has  become  sanguinolent  and  muco-fibrinous,  the 
fluid  contains  these  coccidia  in  considerable  quantities,  and  large  numbers 
of  them  may  be  found  in  the  mucus,  where  they  are  mixed  with  epithelial 
dehris,  blood  corpuscles,  and  lymphatic  cells,  etc.  They  are  rarer  in  the 
clots.  Coccidia  cannot  be  found  in  the  f^ces  of  healthy  animals,  even  in 
those  occupying  the  same  pastures  with  the  diseased.  Should  the  clinical 
symptoms  be  thought  insufficient  of  themselves  clearly  to  identify  the 
disease,  a  simple  microscopic  examination  of  the  faeces  will  remove  any 
doubt. 

Lesions.  Post-mortem  examination  immediately  after  death  enables 
one  exactly  to  identify  the  habitat  of  the  parasite  and  the  lesions  it  pro- 
duces. These  lesions  are  to  be  found  throughout  the  large  intestine, 
from  the  caecum  to  the  anus. 

The  large  intestine  is  almost  or  entirely  empty,  the  mucous  membrane 
is  reddish-brown  in  colour,  lies  in  folds,  is  cedematous,  and  everywhere 
covered  with  a  coating  of  mucus.  This  coating  varies  in  character  at 
different  points ;  in  places  it  forms  more  or  less  thickened  patches  of 
greyish  or  yellowish  colour,  and  of  a  resistant  character,  as  though  mixed 
with  coagulated  fibrin.  These  patches  are  fairly  well  defined,  they  are 
irregular  in  form,  and  vary  in  width  from  some  millimetres  up  to  several 
centimetres.  They  are  more  or  less  adherent  to  the  mucous  membrane, 
from  which  they  can  easily  he  stripped  away.  The  mucous  membrane 
thus  exposed  is  slightly  depressed,  and  of  a  whitish  colour,  thus  markedly 
contrasting  with  the  surrounding  red  coloration.  This  depression  repre- 
sents a  slight  ulceration,  which,  though  superficial,  is  clearly  visible  to 
the  naked  eye. 

Microscopic  examination  of  the  mucus  patches  reveals  the  existence, 
both  superficially  and  in  the  depths,  of  epithelial  cells  derived  from  the 
mucous  membrane,  of  vesicular  cells  derived  from  the  Lieberkuhnian 
follicles,  of  numerous  blood  and  lymphatic  corpuscles,  and,  distributed 
irregularly  throughout  this  mass  of  cells,  of  coccidia,  resembling  those 
found  in  the  dejections. 

In  thin  sections  of  the  intestine,  made  through  the  ulcerated  mucus- 
covered  patches,  and  in  a  direction  perpendicular  to  the  mucous 
membrane,  one  finds  that  the  epithelial  covering  of  the  intestine  has 
disappeared. 

The  Lieberkuhn's  follicles  are  shortened,  their  orifices  are  irregular 
and  partly  blocked  with  epithelial  debris.  In  a  large  number  of  these 
follicles  the  blind  extremity  is  dilated,  and  more  or  less  filled  with  coccidia, 
varying  in  appearance  according  to  their  stage  of  development.  The 
epithelial  cells  normally  lining  these  blind  ends  seem  to  have  disappeared, 

D.c.  T 


274  PARASITES   OF   THE    DIGESTIVE    APPARATUS. 

and  to  have  been  replaced  by  the  parasites.  This,  however,  is  not  really 
the  case.  It  is  easy  to  prove  by  suitable  dissection  (after  maceration  of 
the  sections  in  30  per  cent,  alcohol)  that  the  coccidia  are  lodged  in  epithe- 
lial cells  which  have  become  modified  in  shape  and  undergone  hypertrophy 
as  the  parasite  has  grown,  whilst  the  nucleus  has  been  pushed  to  one  end 
and  undergone  atrophy. 

Alongside  the  deceased  glands  may  be  found  others  which  are  quite 
healthy.  In  the  parts  which  are  most  markedly  affected  the  interglan- 
dular  connective  tissue  is  infiltrated  and  slightly  thickened.  Degoix  has 
never  discovered  coccidia  in  the  cells  of  the  intestinal  mucous  membrane 
itself.  The  lesions  may  be  met  with  throughout  the  large  intestine,  but 
are  more  numerous  and  grave  as  the  rectum  is  approached. 

This  disease  is  characterised  by  extensive  inflammation,  affecting  the 
entire  mucous  membrane  of  the  large  intestine,  by  more  or  less  extensive 
ulceration  of  this  bowel,  the  ulcers  being  covered  with  muco-fibrinous 
patches  rich  in  coccidia,  by  localisation  of  the  parasites  in  the  epithelial 
cells  of  the  glandular  cul-de-sac,  by  the  appearance  of  the  disease  at  a 
special  time  of  year  and  in  special  districts,  where  it  assumes  the  form 
of  an  enzooty,  and  by  the  fact  that  it  always  appears  in  the  same  pastures. 
The  mortality  varies  between  12  and  25  per  cent,  from  year  to  year. 

Microscopic  appearances.  The  protozoa  which  produce  this  disease 
assume  the  form  of  ovoid  cysts,  varying  in  length  from  18  to  25  ^,  and 
measuring  at  the  widest  part  about  13  /x.  They  possess  a  hyaline  envelope 
whose  existence  is  proved  by  its  double  contour  line,  and  yellowish, 
granular,  highly  refractile  contents.  This  granular  material  does  not 
always  occupy  the  whole  of  the  cavity.  At  a  certain  stage  of  develop- 
ment it  collects  towards  the  centre,  forming  a  nucleus  and  leaving  clear 
spaces  at  the  poles  of  the  cell.  At  a  later  stage  this  nucleus  divides  into 
four  portions  which  afterwards  separate. 

Treatment.  The  protozoa,  in  their  cystic  condition,  are  very  resistant 
to  destructive  influences.  The  most  common  natural  cause  of  their  de- 
struction is  drying  in  the  open  air.  Unfortunately,  in  the  localities  where 
the  patients  usually  live,  that  is,  filthy  byres,  wet  pasturages,  etc.,  this 
destruction  only  takes  place  to  a  very  limited  extent. 

The  disease  can  be  attacked  by  prophylactic  and  therapeutic  measures. 

Prophylaxis  consists — firstly,  in  destroying  the  parasites  contained  in 
the  dejections  by  the  free  use  of  3  per  cent,  sulphuric  acid  solution ;  and, 
secondly,  in  removing  the  3^oong  animals  from  infected  fields  during  the 
months  between  June  and  September. 

Therapeutic  treatment  comprises — firstly,  stimulant  applications 
to  the  abdomen ;  secondly,  disinfection  of  the  intestine  by  the  adminis- 
tration of  salol,  benzo-naphthol,  very  diluted  solutions  of  creolin,  etc  ; 
thirdly,  intestinal  irrigation  by  the  administration  of  mucilaginous  drinks 


INTESTINAL   HELMINTHIASIS   IN   RUMINANTS.  275 

containing  bicarbonate  of  soda,  supplemented  by  general  tonic  treatment 

and  the  supply  of  concentrated,  very  nourishing,  and  easily  digested  food 

(Degoix,  Revue  genemle  de  Mcdecine  VHerinaire,  No.  28,  February  15th, 

1904,  p.  177). 

***** 

McFadyean  describes  a  similar  disease  to  the  above  in  two  to  three 
months  old  lambs  {Jour,  of  Comp.  Path,  and  Therap.,  March,  1896,  p.  31). 
The  mortality  reached  10  per  cent.  The  lambs  at  the  time  the  disease 
broke  out  in  the  flock  were  closely  folded  together  with  the  ewes  on 
growing  roots,  which,  needless  to  say,  were  much  soiled  with  earth  and 
fseces  before  they  were  completely  consumed. 

INTESTINAL    HELMINTHIASIS    IN    RUMINANTS 
(Ox,  Sheep,  Goat). 

Verminous  disease  of  the  intestine  is  often  accompanied  by  similar 
disease  of  the  stomach  (gastro-intestinal  strongylosis  of  the  sheep,  lum- 
bricosis  of  the  calf),  but  it  also  occurs  apart  from  the 
presence  of  gastric  parasites.  Parasites  are  more 
frequent  in  the  intestine  than  in  the  abomasum, 
because  the  alkaline  intestinal  juices  prove  a  much 
more  favourable  medium  for  their  development  than 
do  the  acid  juices  of  the  stomach. 

The  actual  parasites  may  include  ascarides,  stron- 
gyles,  hooked  worms,  oesophagostomes,  tricocephales, 
sclerostomes,  and  various  taeniae  (Tcenia  expansa  et 
alba).  Many  of  these  have  already  been,  or  will  here- 
after be,  referred  to.  ^^«-    Ii7--Head    of 

TT-  ,.,,..        ,  ,  ,  ,.,  .  Tcenia   alba  of   the 

Helmmthiasis    due  to    round  worms  like  stron-  -,  ,  ,.., 

ox  and  sheep.  (After 

and   the   various   forms  of   hooked  worm,  is     Neumann.) 


graver  than  that  due  to  flat  worms,  but  most  extra- 
ordinarily varied  collections  are  sometimes  met  with.  Speaking  gene- 
rally, however,  helminthiasis  more  particularly  affects  young  animals 
like  calves,  lambs,  and  yearling  sheep,  is  rarer  in  adults,  and  in  all  cases 
the  complications  it  produces  are  of  trifling  importance  in  adults  as  com- 
pared with  those  caused  in  the  young. 

The  persistence  of  verminous  diseases  in  certain  infested  countries, 
districts,  farms,  or  pastures  is  explained  by  the  enormous  number  of  eggs 
or  embryos  passed  with  the  faeces  and  disseminated  with  manure,  as  well 
as  by  the  high  degree  of  resistance  of  the  eggs  and  embryos  to  destructive 
influences. 

Causation.  The  various  forms  of  intestinal  helminthiasis  are  all  due 
to  embryos  or  eggs  of  worms  obtaining  entrance  to  the  stomach  or  bowels 

T  2 


276 


PARASITES   OF   THE   DIGESTIVE   APPARATUS. 


of  suscepti])le  animals.  Nevertheless,  external  conditions  largel}^  favour 
infestation.  The  existence  of  marshes,  ponds,  and  stag- 
nant water  on  certain  pastures,  heavy  annual  rainfall, 
the  occurrence  of  wet  seasons,  etc.,  favour  the  existence 
and  growth  of  embryos,  and,  as  a  consequence,  the  in- 
festation of  animals. 

The  symptoms  of  intestinal  helminthiasis  are  always 
very  vague,  whether  the  victims  be  oxen,  sheep,  or  goats. 
They  point  to  the  slow  and  progressive  development  of 
a  pernicious  anremia,  characterised  primarily  by  inter- 
ference with  appetite  and  digestion,  then  by  anaemia, 
and  finally  by  cachexia.  The  patients  are  dull,  lose 
condition,  suffer  from  depraved  appetite,  and,  during 
the  cachectic  period,  from  diarrhoea,  and  die  in  a  con- 
dition of  exhaustion.  These  forms  of  helminthiasis  are 
much  more  frequent  in  sheep  than  in  oxen. 

The  diagnosis  is  only  arrived  at  by  discovering 
parasites  in  the  fteces,  or,  in  those  doubtful  cases  where 
one  has  been  led  to  make  a  microscopic  examination 
of  the  excrement,  by  the  detection  of  large  numl)ers 
of  eggs. 

From  an  economic  standpohit  the  prognosis  is  grave, 
l)ecause  severely  infected  animals  recover  their  condi- 
tion very  slowly,  whatever  treatment  be  adopted. 

Treatment  includes  the  measures  previously  indi- 
cated regarding  the  destruction  of  germs,  eggs,  or  em- 
Ijryos  distributed  over  the  pastures,  and  the  drainage  of 
wet  grounds  and  stagnant  pools.  Where  such  diseases 
are  common,  the  pastures  should  be  dressed  with  iron 
sulphate,  and  the  stable  manure  disinfected  or  burned. 

Curative  treatment  comprises  the  administration  of 
such  anthelmintics  as  can  be  given  with  the  food.  They 
should  not  require  to  be  administered  by  force,  as  this 
proceeding  would  not  only  necessitate  a  great  loss  of 
time,  but  might  result  in  accidents. 

Arsenious  acid,  in  doses  of  15  grains  per  day,  and 
tartar  emetic,  in  doses  of  75  to  150  grains,  according  to 
the  animal's  size,  are  among  the  best  drugs  for  oxen,  and 
may  be  given  for  four  or  five  days  running.  Benzine, 
oil  of  turpentine,  and  empyreumatic  oil  are  more  diffi- 
cult to  administer. 
In  the  case  of  sheep,  preference  should  be  given  to  areca  nut, 
in   doses  of  75   to  120  grains,  according  to  the  animal's  size,   and  to 


\ 

1 

Fig.  118 

.—Adult 

specimen  of  the 
fringed      tape- 
worm   {Thi/m- 

nosoma  actini- 
oides).      (After 
Stiles,  1893.) 

INTESTINAL   HELMINTHIASIS   IN   RUMINANTS. 


277 


tansy,  which  are  convenient  to  give,  and  can  be  added  to  bran,  oats,  or 
beetroot. 

Adult  tapeworms  of  oxen  are  of  relatively  minor  importance,  but  one 
tapeworm  of  sheep,  viz.,  the  fringed  tapeworm  {Thysanosoma  actinioides), 
also    known    as    Tuniia  JiiKhviata ;    Moniezia  funhnaia    deserves    notice. 


Fig.  119. — Ventral  and  apex  views  of  the  head  of  the  fringed  tapeworm 
{Thijsanosoma  actinioides).      X  17.     (After  Stiles,  1893.) 

as   at   times   it   forms   a   veritable    scourge   to    the    sheep   industry   of 
North  America  and  South  America. 

Disease.  The  disease  in  sheep  caused  by  the  fringed  tapeworm  has 
l)een  studied  in  detail  by  Curtice,  who  considers  that  next  to  scab  it  is 
the  most  important  sheep  disease  of  the  western  plains  of  North  America. 
The  financial  loss  it  causes  is  extensive,  and  results  from  the  failure  of 
the  lambs  to  fatten,  the  small  crop  of  wool,  and  the  weakening  of  the 
animals,  so  that  they  cannot  withstand  cold  winter  weather.  The  para- 
sites develop  slowly,  and  are  present  in  considerable  numbers  before  their 


Fig.  120. — Segments  of  the  fringed  tapeworm  {Thysanosoma  actinioides), 
showing  canals  and  nerves,  and  (/)  frmged  border,  {t)  testicles,  and  {ut) 
uterus.     Enlarged.     (After  Stiles,  1893.) 


presence  is  suspected.  Toward  September  the  lambs  fail  to  grow  as  they 
should  ;  in  November  the  symptoms  are  marked.  First,  the  w^orms  pro- 
duce local  irritation  of  the  intestine,  which  finally  develops  into  a  chronic 
catarrhal  inflammation  ;  their  presence  in  the  gall-ducts  produces  similar 
results,  and  obstructs  the  flow  of  bile  ;  infected  lambs  are  large-headed, 
under-sized,  and  hide-bound  ;  their  gait  is  rheumatic,  and  they  appear 
more  erratic  than  the  other  sheep,  standing  oftener  to  stamp  at  the 
sheep-dogs  or  herds,  and  lagging  behind  the  flock  when  driven  ;    the 


278  PARASITES   OF   THE    DIGESTIVE    APPARATUS. 

general  symptoms  are  those  of  malnutrition,  and  Curtice  considers  them 
nearly  identical  with  the  symptoms  of  the  "  loco  "  disease  ;  in  fact,  he 
states  that  it  is  extremely  difficult  to  distinguish  between  the  two  diseases, 
and  believes  that  the  fact  that  the  worms  "  may  tend  to  produce  depraved 
appetites  and  a  morbid  craze  for  a  particular  food  is  also  reason  for  sus- 
pecting that  the  loco  disease  may  depend  on  the  tapeworm  disease." 
General  systemic  disturbances  result  from  malnutrition ;  the  usual  fat 
is  absent ;  serous  effusions  are  noticed  in  the  body-cavities,  serous  infil- 
tration in  the  connective  tissue. 

Treatment  is  similar  to  that  of  parasitic  gastro-enteritis  of  sheep  and 
lambs  (wliich  see). 


CHAPTER     IX. 
DISEASES    OF    THE    LIVER. 

From  the  physiological  standpoint  the  liver  is  an  organ  of  such  im- 
portance that  its  pathology  should  be  studied  as  completely  as  possible. 
Furthermore,  it  is  often  the  seat  of  a  number  of  varying  lesions,  either  of 
parasitic,  toxic,  infectious,  or  cancerous  origin. 

In  animals  of  the  bovine  species  the  liver  is  placed  in  the  right  retro- 
diaphragmatic  region,  so  that  it  is  somewhat  difficult  to  examine  by  any 
of  the  ordinary  methods,  like  palpation  and  percussion.  Under  normal 
conditions  it  is  entirely  concealed  beneath  the  hypochondrium,  except 
towards  the  upper  margin  of  the  thirteenth  rib,  where  it  can  be  examined 
by  palpation.  When,  as  in  various  morbid  conditions,  it  is  considerably 
increased  in  size,  it  extends  as  far  as  the  margin  of  the  hypochondriac 
circle,  thus  becoming  directly  accessible  to  palpation  and  percussion. 
Sometimes  it  even  enters  the  hypochondriac  region,  passing  outside  the 
omasum  and  abomasum,  which  it  then  thrusts  towards  the  middle  of  the 
abdominal  cavity. 

The  margin  of  the  liver  exhibits  a  depression  lodging  the  gall  bladder 
nearly  opposite  the  centre  of  its  vertical  depth. 

As  the  liver  is  so  deeply  situated,  percussion  is  found  to  be  the  method 
of  examination  which  gives  the  best  results.  Beyond  the  limits  of  the 
zone  of  auscultation,  percussion  gives  above  a  semi-dull  sound,  then, 
proceeding  downwards,  a  dull  sound  due  to  the  liver,  the  omasum,  and 
the  collection  of  liquid  in  the  bowel.  When  this  dulness  is  well  defined, 
clear,  broad  from  above  downwards,  and  extends  to  or  beyond  the  hypo- 
chondrium, it  indicates  hypertrophy  of  the  liver.  By  deep  palpation  of 
the  posterior  margin  of  the  hypochondrium  the  liver  can  then  be  sounded, 
and  its  excessive  size  detected. 

The  symptomatology  of  the  liver  is  still  very  imperfectly  understood, 
for  in  practice  the  urine  is  rarely  tested  for  bile  pigments,  nor  attempts 
made  to  ascertain  whether  the  glycogenic  function  is  normal  by  the  test 
for  alimentary  glycosuria. 

In  this  connection  nothing  has  yet  been  done  to  assist  in  diagnosing 
certain  hepatic  conditions.  Fortunately,  those  diseases  of  the  liver 
which  we  have  to  study  are  more  often  of  a  parasitic  nature  than  true 
diseases  of  the  hepatic  tissue. 


280  DISEASES   OF   THE    LIVER. 

The  reported  cases  of  venous  or  biliary  cirrhosis,  moreover,  are  too  ill- 
defined  and  too  incomplete  to  be  taken  as  a  type  for  description.  We 
leave  them  on  one  side.  In  a  similar  way,  apart  from  parasitic  cholan- 
geitis  and  cholecystitis,  inflammations  of  the  biliary  ducts  are  little 
known,  and  are  rare. 

CONGESTION    OF    THE  LIVER. 

In  bovine  pathology  only  passive  congestion  of  the  liver,  often  a  result 
of  various  primary  affections  with  cardiac  lesions,  is  well  recognised. 

Active  congestions  probably  occur  during  infections  or  intoxica- 
tions of  various  kinds,  but  have  not  been  made  the  object  of  special 
research. 

Among  diseases  likely  to  produce  passive  congestion  must  be  included 
all  those  which  interfere  with  the  return  circulation  through  the  posterior 
vena  cava.  All  cardiac  affections  with  lesions  of  the  valves  or  orifices  of 
the  right  heart,  all  forms  of  pericarditis,  tumours  or  lesions  of  the 
mediastinum  compressing  the  posterior  vena  cava,  produce  stasis, 
passive  congestion,  and  progressive  development  of  what  is  called 
"  cardiac  liver." 

Symptoms.  The  liver  is  considerably  hypertrophied,  as  a  consequence 
of  the  stasis  of  blood  and  progressive  dilatation  of  the  portal  system.  Its 
zone  of  dulness  increases  in  size,  whilst  on  palpation  its  borders  may 
sometimes  be  detected.  This  condition  is  always  accompanied  by 
digestive  disturbance. 

The  function  of  the  liver  is  more  or  less  interfered  with ;  the  urine  is 
scanty  in  amount  and  charged  with  deposit.  Ascites  of  varying  intensity 
frequently  occurs  ;  cardiac  disturbance  accompanies  or  usually  precedes 
the  above  symptoms. 

The  lesions  of  passive  congestion  are  represented  by  progressive 
dilatation  of  the  entire  portal  venous  system  (nutmeg  liver).  In  time 
this  dilatation  may  produce  biliary  cirrhosis,  as  a  result  of  chronic 
irritation  of  the  blood-vessels  and  perivenous  inflammation.  This 
condition  is  known  as  "  cardiac  cirrhosis  of  the  liver." 

The  diagnosis  of  this  pathological  condition  is  generally  easy,  provided 
that  the  primary  disease  which  causes  it  be  recognised. 

The  prognosis  is  always  grave,  and  the  practitioner  is  limited  to 
treating  the  primary  affection,  such  as  endocarditis,  pericarditis,  etc. 

NODULAR    NECROSING    HEPATITIS. 

This  form  of  inflammation  of  the  liver  is  somewhat  rare  in  animals  of 
the  bovine  species.  The  disease  is  difficult  to  diagnose,  and  is  often  only 
recognised  on  post-mortem  examination. 


NODULAR   NECROSING   HEPATITIS. 


281 


Isolated  tracts  of  the  liver  become  inflamed,  between  which  the  rest  of 
the  tissue  preserves  its  normal  character ;  the  parts  affected  appear  to 
undergo  complete  degeneration,  the  cause  of  which  is  difficult  to 
explain.  On  examining  affected  animals  after  death,  the  liver  is  found 
to  be  greatly  enlarged,  and  apparently  invaded  by  multiple  tumours.  On 
section,  the  parenchyma  generally  is  of  normal  colour,  but'  the  diseased 
parts  are  represented  by  dirty  greyish-yellow  tissue  of  a  lardaceous 
character,  somewhat  resistant  to  the  knife. 

The  affected  spots  vary  in  size,  between  that  of  a  lentil  or  hazel  nut 
and  an  egg,  and  are  formed  of  necrotic  tissue. 

The  periphery  is  the  seat  of  true  chronic  fibro-plastic  inflammation. 

Causation.  According  to  Stabbe,  these  lesions  are  produced  by 
microbes,  originating  -in  the  intestines,  and  carried  to  the  liver  by  the 


Fig.  121. — Appearance  of  the  liver  in  necrosing  hepatitis 


mesenteric  veins.  The  lesions  and  blood  of  the  liver  yield  cultures  of  a 
microbe  resembling  that  of  necrosis  ;  nevertheless,  such  lesions  have  not 
been  experimentally  reproduced. 

According  to  Berndt,  infection  from  the  uterus  is  possible,  and  indeed 
probable.  Moussu  has  only  seen  three  cases  of  this  particular  condition 
of  the  liver  in  living  animals.  Two  of  these  were  in  a  working  ox  and  a 
bull  respectively,  so  that  Berndt's  view  would  not  seem  to  be  exclusively 
applicable.  Moussu  is  convinced  that  infection  is  of  intestinal  origin, 
and  that  it  takes  place  through  the  mesenteric  veins  ;  he  claims  to 
have  found  the  proof  of  this  in  the  existence  of  multiple  pylephlebitis 
and  complete  obliteration  of  the  subhepatic  veins  in  some  cases. 

Symptoms.  The  symptoms  are  so  vague  as  to  render  diagnosis  diffi- 
cult.    Berndt,  on  the  other  hand,  regards  it  as  fairly  easy.     He  states 


282  DISEASES    OF   THE   LIYER. 

that  the  disease  occurs  in  old  cows,  which  after  parturition  show  loss  of 
appetite,  polydipsia,  fever,  dyspnoea,  and  short,  feeble  cough,  suggesting 
pneumonia.  After  a  few  days  the  animals  appear  extremely  weak, 
remain  lying  for  long  periods,  and  exhibit  icterus.  Percussion  of  the 
liver  detects  abnormal  sensibility  and  hypertrophy. 

The  three  cases  seen  by  Moussu  showed  only  slight  yellowness  of  the 
membranes,  general  weakness  and  difficulty  in  walking,  which  at  first 
glance  appeared  to  suggest  laminitis,  marked  hypertrophy  of  the  liver, 
sensitiveness  over  the  hepatic  region,  and,  as  complications,  uncontrollable 
diarrhcea  and  peritonitis.  But  these  symptoms  are  also  noted  in  suppu- 
rating echinococcosis,  and  even  in  cancer  of  the  biliary  ducts,  so  that 
diagnosis  does  not  appear  easy.  Nevertheless,  there  is  alwaj's  marked 
fever,  and  on  post-mortem  examination  it  is  not*  unusual  to  find,  in 
addition  to  the  hepatic  lesions,  a  certain  amount  of  perihepatitis,  partial 
peritonitis,  and  even  pleurisy  in  the  region  of  the  diaphragm.  The 
question  is  of  little  practical  importance,  for  the  gravity  of  the  disease 
just  described  is  such  that  economically  no  treatment  is  possible.  The 
great  point  lies  in  correctly  diagnosing  disease  of  the  liver,  and  that  is 
relatively  easy. 

CANCER    OF    THE    LIVER    AND    BILE    DUCTS. 

Cancer  of  the  liver,  that  is,  broadly  speaking,  the  development  in  the 
liver  of  malignant  tumours,  capable  of  becoming  generalised  throughout 
the  organism,  is  comparatively  rare  when  compared,  with  parasitic 
diseases  of  the  same  organ.  It  may  be  primary  or  secondary  in 
character,  but  is  much  more  frequently  secondary.  In  bovines  primary 
cancer  assumes  the  forms  of  adenomata,  trabecular  epitheliomata,  or 
adeno-carcinomata.  Moussu  describes  a  case  in  which  the  growths 
assumed  the  form  of  papillomata  or  adeno-papillomata  extending 
throughout  the  biliary  ducts,  and  partly  obstructing  the  common  bile 
duct,  which  was  greatly  dilated. 

The  real  cause  of  these,  as  of  all  other  primary  tumours,  remains 
shrouded  in  mystery. 

Secondary  cancer  is  more  frequent ;  it  occurs  usually  in  the  form 
of  little  isolated  tumours  (nodular  cancer)  of  varying  size  and  greyish 
colour. 

Symptoms.  Clinically  the  description,  or  rather  the  identification, 
of  cancers  of  the  liver  is  difficult,  and  the  diagnosis  particularly  trouble- 
some in  cases  of  primary  cancer. 

In  secondary  cancer  (following  tumour  of  the  testicle  in  oxen  castrated 
by  the  method  of  bistournage,  for  example)  the  general  condition,  on  the 
other  hand,  is  usually  so  afiected  that  attention  is  pointedly  drawn  to  the 


ECHINOCOCCOSIS   OF   THE   LIVER. 


283 


seat  of  the  secondary  growths.     The  patients  lose  appetite,  the  fteces 
become  foetid,  and  diarrhoea  sets  in  without  clear  signs  of  enteritis. 

Examination  of  the  liver  always  reveals  hypertrophy,  and  sometimes 
sensitiveness.  The  patients  rapidly  lose  flesh,  become  cachectic,  and  the 
proportionate  number  of  red  blood  corpuscles  diminishes.  From  the 
normal  of  six  or  seven  millions  the  number  may  fall  to  one  million  or 
less,  while  that  of  the  white  corpuscles  considerably  increases.  This 
leucocytosis,  which  accompanies  all  forms  of  visceral  cancer,  enables 
one  to  distinguish  between  cancer  and  chronic  forms  of  diarrhoeic  enteritis ; 
it  must  not  be  confused  with  leucaemia.  Moderately  developed  ascites  is 
common,  in  consequence  of  obstruction  in  the  porto-hepatic  circulation. 


Fig.  122. — Poition  of  pig's  liver  infested  with  echinoccocus  hydatid,  natural 
size.     (Stiles,  Annual  Report,  U.S.A.  Department  of  Agriculture,  1900.) 

The  diagnosis  of  cancer  of  the  liver  or  biliary  ducts  is  surrounded 
with  difficulty,  and  the  prognosis  is  extremely  grave,  because  no  treatment 
is  possible. 

ECHINOCOCCOSIS    OF    THE    LIVER. 

This  term  is  applied  to  the  development  in  the  depths  of  the  hepatic 
parenchyma  of  hydatids  of  Tcenia  ecldnococcus. 

The  echinococcus  113  datid  is  found  in  man,  cattle,  sheep,  swine,  etc. 
It  represents  an  intermediate  stage  of  development  of  the  echinococcus 
tapeworm  of  dogs.  Since  this  parasite  develops  its  larval  stage  in 
man  also,  and  further,  since  it  is  the  most  dangerous  animal  parasite 
found  in  man,  it  is  important  to  thoroughly  understand  its  life  history 
in  order  to  guard  against  infection. 

Adult  stage  {Tccnia  echinococcus). 


284 


DISEASES    OF   THE   LIVER. 


Hosts.     Dog,  dingo,  jackal,  wolf. 

Life  history.  Starting  with  the  adult  tapeworm  (Fig.  124)  in  the 
small  intestine  of  the  dog  or  wolf,  the  eggs  are  scattered  over  the  ground 
and  are  swallowed  hy  the  intermediate  host  with  the  fodder  or  water. 
Upon  arriving  in  the  stomach  the  egg-shell  is  destroyed,  and  the  six- 


Fia.  123. — Portion  of  the  intestine  of  a 
clog  infested  with  the  adult  hydatid 
tapeworm  (^Tivnia  echinococcus, 
natural  size.     (After  Ostertag,  1895.) 


Fig.  125. — Hooks  of  adult  hydatid  tape- 
worm, a,  From  a  hydatid  ;  h,  three 
weeks  after  feeding  to  a  dog  ;  c,  from 
an  adult;  d,  combined  figures  of  a — c, 
showing  the  gradual  changes  in  form. 
X  600.     (After  Leuckart,  1880.) 


Fig.  124.— Adult  hydatid  tapeworm 
{Tcrnia  ccliinococctis)  enlai-ged. 
(After  Leuckart,  1880.)     . 


hooked  emhryo,  which  is  thus  freed,  hores  its  way  through  the  intestinal 
wall,  and  wanders,  actively  or  passively  (that  is,  carried  along  hy  the 
blood),  to  various'  organs  of  the  body — liver,  lungs,  ovaries,  bones,  skull, 
etc. — where  it  develops  first  into  an  accjiludoci/st,  which  may  develop 
further,  as  shown  by  the  accompanying  illustrations.  The  heads  which 
are  formed,  upon  being  devoured  by  a  dog  or  wolf,  then  develop  into 
adult  tapeworms. 


ECHINOCOCCOSIS   OF   THE   LIVER. 


285 


Young  animals  are  most  exposed  to  this  disease ;  in  adults  or  aged 
animals  the  migration  and  development  of  the  embryo  are  more  difficult. 


Fig.  126. — Diagram  of  an  echinococcus  hydatid,  oi,  Thick  external  cuticle  ; 
'pa,  parenchyni  (germinal)  layer  ;  c,  d,  e,  development  of  the  heads, 
according  to  Leuckart ;  /,  g,  h,  i,  7c,  development  of  the  heads  accord- 
ing to  Moniez  ;  I,  fully-developed  brood  capsule  with  heads;  j)i,  the 
brood  capsule  has  ruptured,  and  the  heads  hang  into  the  lumen  of 
hydatid  ;  n,  liberated  head  floating  in  the  hydatid  ;  o,  j),  q,  r,  s,  mode  of 
formation  of  secondary  exogenous  daughter  cyst ;  t,  daughter  cyst  with 
one  endogenous  and  one  exogenous  grand-daughter  cyst ;  «,  v,  x,  foi-ma- 
tion  of  endogenous  cyst,  after  Kuhn  and  Davaine  ;  y,  z,  formation  of 
endogenous  daugliter  cysts,  after  Naunyn  and  Leuckart ;  y,  at  the 
expense  of  a  head,  .?,  from  a  brood  capsule;  evag,  constricted  portion 
of  the  mother  cyst.     (After  K.  Blanchard,  1886.) 

These  embryos  perforate  the  tissue  of  the  liver,  become  fixed  in  it, 
and  derive  from  it  the  nourishment  necessary  for  their  conversion  into 
cystic  bladders  of  varying  size,  either  sterile  or  fertile. 

The  number  of  vesicles  is  rarely  large,  and  when  only  one  or  two  are 


286 


DISEASES   OF   THE   LIVER. 


Fig.  127.  —A  racemose  echino- 
coccus,  natural  size.  (After 
Leuckart,  1880.) 


present  the}'  seldom  produce  sufficient  disturbance  to  attract  attention. 

On  the  other  hand,  ^Yhen  numerous  they  deform  the  liver,  produce 
glandular  atrophy,  increase  the  total  size  of 
the  organ,  and  lead  to  the  appearance  of 
clearly-marked  symptoms. 

The  cystic  vesicles  contain  a  clear,  limpid, 
transparent  fluid,  in  which  float  secondary, 
daughter,  or  granddaughter  vesicles. 

Symptoms.  Echinococcosis  of  the  liver 
has  no  well-marked  sj'mptoms,  and  is  there- 
fore difficult  to  diagnose  in  animals  whose 
liver  is  deeply  seated,  and  therefore 
beyond  palpation.  The  signs  which  may 
characterise  the  period  of  penetration  of  the 
embryos  through  the  intestine  and  into  the 
depths  of  the  liver,  and  which  are  probably 
represented  by  slight  colic,  vague  pain  and 
diarrhoea,  usually  pass  unnoticed.  But  later, 
when  the  liver  is  extensively  invaded  ap- 
petite becomes  irregular  without  apparent 
cause,  animals   show  intractable    diarrhoea, 

general  feebleness,  dulness,  and  wasting. 

These  symptoms  do  not  point  with  sufficient  clearness  to  a  special 


Fig.  128. — Section  through  a 
multilocular  eehiiiococcus. 
X  30.  (After  Leuckart, 
1880.) 


Fig.  129.— a  nuiltilociilar  echino- 
coccus  from  the  hver  of  a  steer, 
natural  size.  -  (After  Ostertag, 
1895.) 


Fig.  130. — A  multilocular  echino- 
coccus  from  the  pleura  of  a  hog, 
natural  size.  (After  Ostertag, 
1895.) 


ECHINOCOCCOSIS   OF   THE   LIVER. 


287 


ifiili 


Fio.  131. — Echinococcus 
bladder  worm  or  hydatid. 


visceral  lesion,  but  as  they  call  for  a  complete  examination,  the  prac- 
titioner is  almost  forced  to  a  certain  conclusion  by  the  fact  that  the 
examination  remains  negative  except  in  re- 
gard to  the  liver.  The  liver  seems  large  and 
sensitive,  and  may  sometimes  be  considerably^ 
hypertrophied,  for  cases  have  been  seen  in 
the  ox  where  the  normal  weight  of  10  to  12 
lbs.  has  been  increased  to  60  or  even  100  lbs., 
while  in  the  pig,  whose  liver  normally  weighs 
4  lbs.,  the  weight  has  been  as  high  as  20  or 
40  lbs.  In  such  cases  percussion  and  pal- 
pation show  that  the  liver  extends  beyond  the 
right  hypochondriac  region  and  invades  a 
large  portion  of  the  corresponding  flank.  But 
such  great  enlargement  is  exceptional,  and 
when  only  a  dozen  vesicles  are  present,  al- 
though the   functions   of   the   liver   may  be 

seriously  disturbed,  the  information  obtained  by  physical  examination 
is  seldom  sufficient  to  justify  an  exact  diagnosis.  The 
liver  is  found  to  be  enlarged  and  thickened ;  otherwise 
the  examination  gives  negative  results. 

The  diarrhoea  may  result  from  failure  of  the  liver  to 
secrete  sufficient  bile  to  destroy  intestinal  toxins,  or  to 
carry  on  its  glycogenic  function ;  but  it  may  possibly  be 
the  direct  result  of  chronic  intoxication  by  the  contents 
of  the  vesicles. 

Experience  has  shown,  in  fact,  that  in  man,  when  a 
superficial  vesicle  becomes  ruptured,  the  peritoneal  cavity 
is  flooded  with  the  contents  of  the  cyst ;  the  daughter 
cysts  adhere  to  the  peritoneum,  and  that  almost  invari- 
ably vascular  disturbance  occurs,  accompanied  by  itching 
of  the  skin  and  an  eruption  resembling  that  of  urticaria. 
The  liquid  of  the  vesicles  contains  an  active  tox- 
albumin. 

Diagnosis.  In  certain  cases,  diagnosis  is  possible,  and 
even  easy,  l)ut  in  others  it  is  extremely  difficult  and  ahnost 
impossible. 

Prognosis.     The  prognosis  is  always  grave,  for  if  the 

lesions  in  the  liver  do   not   produce  death,   as   usually 

happens,  they  so  profoundly  aflect  the  animals'  general 

state,  that  it  is  no  longer  worth  while  to  keep  them  alive. 

No  practical  treatment  exists.     In  exceptional  cases  it  certainly  might 

be  possible,  although  in  the  large  herbivora  always  difficult,  to  expose 


Fig.    132.     — 

Tceninecliino- 


288 


DISEASES   OF   THE   LIVER. 


the  liver  and  to  puncture  and  evacuate  the  contents  of  some  of  the 
cysts ;  but  the  result  would  he  illusory,  because  some  vesicles  would 
always  be  inaccessible,  and  economically  intervention  would  be  incomplete 
and  useless. 

Although  there  is  no  useful  method  of  treatment,  prophylaxis  is 
possible  and  valuable.  It  consists  in  preventing  the  development  of 
tfeniffi  in  farm  and  sporting  dogs.  For  this  purpose  it  is  sufficient  to 
prevent  their  obtaining  raw  offal  containing  vesicles  of  echinococci  from 
sheep,  oxen,  or  pigs,  and  also  to  free  them  from  any  helminths  which 
they  may  harbour.     In  this  way  they  no  longer  spread  eggs  of  ta^nise 


^^t'Col&c  axl  n/3^  <^' 


Fig.  133. — Pig's  liver  with  echinococcus  cysts.     (After  Eailliet.) 

with  their  hieces  in  the  neighl)ourliood  of  ponds  or  drinking  places,  and 
the  cattle  do  not  ingest  the  embr3^os. 


SUPPURATIVE    ECHINOCOCCOSIS. 

Causation.  Simple  echinococcosis  may  remain  undetected  for  a  long 
time,  and  young  animals  affected  with  it  may  grow  up  without  exhibiting 
marked  general  disturbance.  The  old  echinococci  end  by  degenerating, 
the  wall  of  the  cyst  becomes  modified,  the  liquid  it  contains,  turbid, 
lactescent,  then  caseous ;  the  vesicle  becomes  wrinkled,  and  finally 
nothing  resembling  the  primary  vesicle  remains.  The  liquid  is  soon 
absorbed,  and  the  primary  cyst  is  only  represented  by  a  caseous  magma, 
which  undergoes  calcareous  infiltration  and  progressive  atrophy. 

Under   other  circumstances   the    development   of    the-  echinococcus 


SUPPURATIVE   ECHINOCOCCOSIS.  289 

vesicles  is  less  regular ;  they  may  become  accidentally  infected  and 
transformed  into  encysted  abscesses,  constituting  suppurative  echino- 
coccosis of  the  liver.  The  membrane  of  the  vesicles  usually  resists  the 
passage  of  microbes,  but  the  fibrous  tissue  surrounding  the  cyst  is  very 
vascular ;  and  if,  in  consequence  of  vascular  disturbance  in  the  liver 
(which  may  result  simply  from  feeding,  trifling  infection  or  other  visceral 
disease),  the  blood  should  for  a  short  time  be  infected,  microbes  pene- 
trate through  solutions  of  continuity  in  the  wall  of  the  vesicle,  which 
becomes  a  centre  of  suppuration.  The  liquid  becomes  turbid,  the  primary 
cyst  is  transformed  into  an  abscess,  and  suppurative  echinococcosis  is 
set  up. 

Symptoms.  The  general  condition  resulting  from  the  development 
of  suppuration  in  echinococcus  cysts  is  very  different  from  that  of  true 
echinococcosis.  If  the  abscess  develops  rapidly,  acute  generalised  peri- 
tonitis or  localised  peritonitis  of  the  right  anterior  abdominal  region 
may  almost  immediately  occur,  producing  all  the  characteristic  symptoms 
of  ordinary  peritonitis.  In  all  cases,  even  in  the  absence  of  well-marked 
peritonitis,  perihepatitis  occurs,  and  the  liver  becomes  adherent  to  the 
posterior  surface  of  the  diaphragm,  to  the  hypochondriac  region,  to  the 
abdominal  wall,  or  to  one  of  the  gastric  compartments. 

This  perihepatitis  is  indicated  by  exceptional  sensitiveness  in  the  right 
hypochondriac  region,  and  by  respiratory  disturbance  due  to  fixation  of 
the  diaphragm. 

In  certain  cases  these  abscesses  seem  to  develop  like  "  cold  "  abscesses 
— i.e.,  without  fever,  and  this  without  producing  very  marked  digestive 
disturbance ;  but  the  patients  waste  rapidly,  become  weak,  show  slight 
subicteric  coloration  of  the  membranes,  and  appear  to  lose  their 
strength.  Movement  is  slow  and  hesitating,  as  though  the  animals 
were  suffering  from  laminitis,  the  anaemia  becomes  more  marked  from 
day  to  day,  and  examination  of  the  blood  reveals  abundant  leucocytosis, 
the  existence  of  which  often  assists  in  the  diagnosis  of  internal  suppura- 
tion. In  a  few  months,  at  least  in  the  cases  we  have  seen,  the  animals 
become  cachectic. 

In  other  and  still  more  obscure  cases  suppuration  of  the  liver  is 
accompanied  by  total  hypertrophy,  excessive  sensitiveness  in  the  right 
hypochondriac  region,  progressive  loss  of  appetite,  excessive  thirst,  and 
uncontrollable  diarrhoea  and  fever,  although  in  the  case  mentioned  above 
there  was  little  fever  and  no  diarrhoea.  The  course  of  these  cases,  which 
probably  result  from  intestinal  infection,  is  much  more  rapid.  In  a 
fortnight  or  three  weeks,  sometimes  less,  the  patients  are  carried  off  by 
intoxication,  generalised  purulent  infection,  or  septicemia. 

Diagnosis.  The  diagnosis  of  suppurative  echinococcosis  and  of 
primary   abscess  of   the  liver   is    difticult  to  establish.     It  is  attained 

D.C.  U 


290 


DISEASES   OF   THE   LIVER. 


Fig.  134.— Thin  -  necked 
bladder  -  worm  {Cysti- 
cercus  tenuicollis),  with 
head  extruded  from 
body,  from  cavity  of 
a  steer,  natm-al  size. 
(Stiles,  Annual  Report, 
U.S.A.  Bureau  of  Agri- 
culture, 1901.) 


chiefly  by  a  process  of  exclusion,  though  the  signs 
furnished  by  percussion  of  the  right  flank,  and  by 
examination  of  the  blood, 
are  of  some  assistance. 

Prognosis.  The  prog- 
nosis is  extremely  grave. 
Treatment  is  of  little 
value.  Even  supposing 
that  the  diagnosis  has  been 
exact,  surgical  intervention 
is  out  of  the  question,  and 
only  this  would  appear 
theoretically  to  ofi"er  a 
chance  of  success.  The 
abscesses  are  multiple, 
deeply  placed,  separated 
from  one  another,  and 
sometimes  surrounded  by 
enormous  tracts  of  in- 
flamed tissue.  In  fact,  the  condition  is  of  such  a 
character  as  entirely  to  prohibit  active  measures. 

CYSTICERCOSIS. 

This  disease  is  produced  hy  the  thin-  or  long- 
necked  bladder-worm  {Ct/sticercus  tcuuicoUis)  found 
_  in  cattle,  sheep,  and  swine. 

The  cj^sticercus  rej)resents 
an  intermediate  stage  of  de- 
velopment of  the  marginate 
tapeworm  {Ttema  margi- 
nata)  of  dogs  and  wolves. 
It  is  by  no  means  un- 
common in  Europe  and 
America,  and  occurs  in  the 
body  cavity  of  cattle,  sheep, 
swine,  and  other  animals, 
attached  to  the  diaphragm, 
omentum,  liver,  or  other 
organ. 

When  eaten  by  dogs  or 
wolves,  it  develops  into  the 
marginate  tapeworm,  which  was  formerly  confused 
with    T.    solium    of    man,    and    gave    rise    to   the 


Fig.  136.— Head  of  the 
marginate  tapeworm 
{Tcniia  marginata). 
X  17.  (Stiles,  Annual 
Eeport,  U.S.A.  Bureau 
of  Agriculture,  1901.) 


fcrj 


En 


s^ 


Fig.  135.— The  marginate 
tapeworm  {Tteiiia  mar- 
;/ ill  at  a),  natural  size. 
(Stiles,  Annual  Report, 
U.S.A.  Bureau  of  Agri- 
culture, 1901.) 


CYSTICERCOSIS. 


291 


erroneous  idea  that  the  pork-measle  tapeworm  occurs  in  dogs  as  well 
as  in  man. 

Life  history.     In  tracing  the  life  history  it  is  best  to  begin  with  the 


Fig.  137. — Small  and  large  hooks  of  (A)  Tcenia  marginata,  (B)  T.  serratn,  and  (C) 
T.  ca'Hurus.     a,  Small  hooks  ;  h,  large  hooks,      x  480.     (After  Deffke.) 

egg,  produced  by  the  adult  tapeworm  in  the  intestine  of  dogs.     These 
eggs,  containing  a  six-hooked  embryo,  escape  from  the  dog  with  the 


Fig.  138. — Sexually  mature  segment  of  the  marginate  tapeworm  {Tirnia  marginata). 
cp,  Cirrus  pouch ;  gp,  genitpJ  pore  ;  n,  nerve  ;  ov,  ovary  ;  sg,  shell  gland  ;  t,  testicles 
tc,  transverse  canal;  id,  uterus;  v,  vagina;  vc,  ventral  canal;  vd,  vas  deferens: 
vg,  vitellogene  gland.     Enlarged.     (After  Deffke.) 

u  2 


292 


DISEASES   OF   THE   LIVER. 


excrements,  and  are  scattered  on  the  ground,  either  smgly  or  confined 
in  the  escaping  segments  of  the  tapeworm.  Once  upon  the  ground, 
they  are  easily  washed  along  hy  rain  into  the 
drinking  water,  ponds,  or  hrooks,  or  scattered  on 
the  grass.  Upon  heing  swallowed  with  fodder  or 
water,  they  arrive  in  the  stomach  of  the  inter- 
mediate host  (cattle,  sheep,  etc.),  where  the  egg- 
shells are  destroyed  and  the  embryos  set  free. 
The  embryos  then  traverse  the  intestinal  wall, 
and,  according  to  most  authors,  arrive  either  ac- 
tively, by  crawling,  or  passively,  by  being  carried 
along  by  the  blood,  in  the  liver  or  lungs,  where 
they  undergo  certain  transformations  in  structure. 
While  still  in  the  finer  branches  of  the  blood- 
vessels of  the  liver,  which  they  transform  into 
small,  irregularly-shaped  tubes  about  12  to  15  mm. 
long  and  1  to  1*5  mm.  broad,  the  embryos  lose  their  six  hooks,  and 
develop  into  small,  round  kernels,  which  are  generally  situated  at  one 


Fig.  139.— Egg  of  the 
marginate  tapewonii 
( Tcenia  m argin nta), 
with  six-hooked  em- 
bryo, greatly  magai- 
fied.  (Stiles,  Annual 
Eeport  U.S. A. Bureau 
of  Agriculture,  1901.) 


Fig.  140.— Portion  of  the  liver  of  a  lamb  which  died  nine  days  after  feeding  with  eggs 
of  the  marginate  tapeworm  {Tcenia  marginata),  with  numerous  "scars,"  due  to 
young  parasites.     (After  Curtice.) 

end  of  the  tubes.     The  embryo  can  first  be  seen  about  four  days  after 
infection.     The  "  scars  "  (Figs.  140  and  141)  described  in  the  liver  of 


DISTOMATOSIS— LIVER   FLUKR   DISEASE— LIVER   ROT.  293 

animals  infested  with  Cysticercns  tenuicollis  are  nothing  more  nor  less 
than  these  tubes,  or  altered  blood-vessels,  caused  by  the  growth  and 
wandering  of  the  parasites. 

Curtice  takes  a  somewhat  different  view — that  is,  he  considers  the 
liver  as  a  place  of  destruction  for  the  young  parasites,  rather  than  a 
normal  place  for  their  development;  he  also  claims  that  the  embryos, 
which  may  even  travel  the  entire  length  of  the  intestine  of  the  inter- 
mediate host,  traverse  the  intestine  and  arrive  directly  in  the  position 
where  they  complete  their  larval  development  without  first  passing 
through  the  liver. 

After  developing  into  the  full-grown  bladder  worm,  the  parasites 
remain  unchanged   until   they  are  devoured  by  a  dog  or  wolf,  or  until. 


Fig.  141. — Cross-section  of  the  liver  of  a  lamb  which  died  nine  days  after  feeding  with 
eggs  of  the  niarginate  tapeworm  [Tcenia  marguiatu).     (After  Curtis.) 

after  an  undetermined  length   of  time,   they  become  disintegrated  and 
more  or  less  calcified. 

If  the  hydatid  is  devoured  by  a  dog  or  wolf,  either  when  the  latter 
prey  upon  the  secondary  host  or  when  the  dog  obtains  the  cyst  at  a 
slaughter-house,  the  bladder  portion  is  destroyed,  the  scolex  alone 
remaining  intact  in  the  digestive  fluids.  The  head  holds  fast  to  the 
intestinal  wall  with  its  suckers  and  hooks  ;  by  strobilation  (transverse 
division)  it  gives  rise  to  the  segments,  wdiich  as  we  have  already  seen, 
together  with  the  head,  go  to  make  up  the  adult  tapeworm.  Kepro- 
ductive  organs  of  both  sexes  develop  in  the  separate  segments,  and 
eggs  are  produced,  within  which  are  developed  the  six-hooked  embryos, 
the  point  from  which  we  started. 

DISTOMATOSIS -LIVER    FLUKE    DISEASE -LIVER    ROT. 

In  France  the  name  of  distomatosis  has  been  given  to  a  disease  caused 
by  the  presence  of  distomata  in  the  bile  ducts.  It  is  the  "  liver  rot "  of 
England,  the  Eberfiiule  of  Germany,  and  is  produced  by  the  growth  in 


294 


DISEASES    OF   THE    LIVER. 


the  biliary  ducts  of  oxen,  sheep,  and  goats  of  two  species  of  distomata, 
viz.,  the  Distoma  Iwpaticum  or  Fasciola  Iwpatica,  and  the  Distoma  lanceo- 
latam. 

In  1875  Zundel  established  the  causative  relation  between  the  pre- 
sence of  distomata  in  the  liver  and  the  development  of  progressive  fatal 
cachexia  in  most  of  the  animals  affected.     This 
B  opinion  was  emphasised  by  the  works  of  Leuckart 

and  Thomas  on  the  development  of  distomata, 
and  at  the  present  day  the  parasitic  theory  is 
accepted  as  beyond  question. 

Fasciola  hepatica  {Distoma  hcpaticnin). — The 
connnon  liver  fluke  of  cattle,  sheep,  swine,  etc. 

Life  history.  The  adult  parasite,  instead  of 
producing  young  similar  to  itself  and  capable 
of  developing  directly  into  adults  in  cattle,  pro- 
duces eggs  which  develop  into  organisms  totally 
different  from  the  adult  form,  living  a  parasitic 
life  in  other  animals.  In  scientific  language,  the 
parasite  is  subject  to  an  alternation  of  genera- 
tions, together  with  a  change  of  hosts.  The  fol- 
lowing summary  of  the  life  history  will  make  this  point  clear : — 

(«)  The  adult  Itennaphroditic  worm  (Figs.  144  and  145)  fertilises  itself 
(although  a  cross  fertilisation  of  two  individuals  is  not  impossible)  in  the 
biliary  passages  of  the  liver,  and  produces  a  large  number  of  eggs. 

{b}  Eggs  (Figs.   143,   146  and  147). — Each  egg  is  composed  of  the 


Fig.  142.— Fr^s•r(•o/r 
iica.      A,     yoiin: 
adult  parasite. 
Railliet.) 


Fig.  148.— Eggs  of  Fasciola  Itc^'afica.  A, 
from  the  bile  duct ;  B,  embryonic  ;  C,  after 
opening.     (After  Eailliet.) 


Fig.  144. — Common  liver 
fluke  {Fasciola  hejxi- 
tica),  natural  size. 
(Stiles,  Annual  Report, 
U.S.A.  Bureau  of  Agri- 
culture, 1901.) 


following  parts  :  (1)  A  true  germ  cell,  which  originates  in  the  ovary  and  is 
destined  to  give  rise  to  the  future  embryo ;  (2)  a  numl)er  of  vitelline  or 
yolk  cells,  which  are  formed  in  a  specialised  and  independent  portion 
(vitellogene  gland)  of  the  female  glands — instead  of  developing  into  embryos 
the  yolk  cells  form  a  follicle-like  covering  for  the  true  germ  cell,  and  play 
an  im})ortant  role  in  the  nutrition  of  the  latter  as  it  undergoes  further 


DlSTOMAl'OSlS — LIVER    FLUKE   JDISEASE — LIVER 


295 


3  == ; 


S   5«  -^ 


i. 


o    s 


g  p 


^1 

O      01 


2  ■'^ 


29G 


DISEASES   OF   THE   LIVER. 


development  ;  (3)  a  shell  surrounding  the  germ  cell  and  vitellme  cells, 
and  provided  at  one  end  with  a  cap  or  operculum.  The  eggs  escape  from 
the  uterus  of  the  adult  through  the  vulva,  are  carried  to  the  intestine  of 
the  host  with  the  bile,  then  pass  through  the  intestines  with  the  contents 


Fig.  146. — Egg  of  the  common  liver 
fluke  (Fasciola  heimtica),  exa- 
mined shortly  after  it  was  taken 
from  the  liver  of  a  sheep.  At  one 
end  is  seen  the  lid  or  operculum,  o  ; 
near  it  is  the  segmenting  ovum,  e ; 
the  rest  of  the  space  is  occupied 
by  yoke  cells  which  serve  as  food ; 
all  are  granular,  but  only  three 
are  thus  drawn.  X  680.  (After 
Thomas,  1883,  p.  281,  Fig.  1.) 


^.- 


-^ 


Fig.  147. — Egg  of  the  common  liver 
fluke  containing  a  ciliated  embryo 
(miracidium)  ready  to  hatch  out : 
d,  remains  of  food  ;  e,  cushion  of 
jelly-like  substance  ;  /,  boring  pa- 
pilla ;  h,  eye-spots  ;  A-,  germinal 
cells.  X  680.  (After  Thomas, 
188:-5,  p.  283,  Fig.  2.) 


of  the  latter,  and  are  expelled  from  the  host  with  the  ffecal  matter.  Many 
of  them  become  dried,  and  then  undergo  no  further  development;  but 
others  are  naturally  dropped  in  the  water  in  marshes,  or,  being  drojjped 
on  dry  ground,  they  are  washed  into  water  by  the  rain,  or  are  carried  to 
a  more  favourable  position  by  the  feet  of  animals  pasturing  or  passing 
through  the  fields.     After  a  longer  or  shorter  period  of  incubation,  which 


DISTOMATOSIS — LIVER   FLUKE    DISEASE — LIVER   ROT. 


297 


varies  with  the  temperature,  a  ciUated  emhryo  (mii-acidium)  is  developed. 
At  a  temperature  of  20°  to  26°  C.  the  miracidium  may  be  formed  in  ten 
days  to  three  weeks ;  at  a  temperature  of  16°  C.  the  development  takes 
two  to  three  months;  at  38°  C.  it  ceases  entirely.  Experiments  have 
shown  that  as  long  as  these  eggs  remain  in  the  dark  the  miracidium  will 
not  escape  from  the  egg-shell;  accordingly  it  will  not  escape  during  the 
night.     When  exposed  to  the  light,  however,  or  when  suddenly  brought 


Fig.  148.— Embryo  of  the 
common  liver  fluke  {Fas- 
ciola  hej^atica), horing  into 
a  snail.  X  370.  (After 
Thomas,  1883,  p.  285, 
Fig.  4.) 


Fig.  149. — Sporocyst 
of  the  common  liver 
fluke  which  has  de- 
veloped from  the 
embryo,  and  con- 
tains germinal  cells. 
X  200.  (After 
Leuckart,  1889,  p. 
109,  Fig.  67  B.) 


Fig.  150. — Sporocyst 
of  the  common  liver 
fluke,  somewhat 
older  than  that  of 
Fig.  149,  in  which 
the  germinal  cells 
are  giving  rise  to 
redite.  X  200.  (After 
Leuckart,  1889,  p. 
109,  Fig.  67  C.) 


into  contact  with  cold  water,   the  organism  bursts  the  cap  from  the 
egg-shell,  crawls  through  the  opening,  and  becomes  a — 

(c)  Free-swimming  ciliated  miracidium  (Fig.  148). — As  already  stated, 
this  organism  is  entirely  different  from  its  mother.  It  measures  about 
0*15  mm.  long;  is  somewhat  broader  in  its  anterior  portion  than  in  its 
posterior  portion ;  on  its  anterior  extremity  we  find  a  small  eminence, 
known  as  a  boring  papilla ;  the  exterior  surface  of  the  young  worm  is 
covered  with  numerous  cilia,  which  by  their  motion  propel  the  animal 
through  the  water;  inside  the  body  we  find  in  the  anterior  portion  a 
simple  vestigial  intestine  and  a  double  ganglionic  mass  provided  with  a 
peculiar  pigmented  double  cup-shaped  eye-spot ;  in  the  posterior  portion 


298 


DISEASES   OP   THE    LIVER. 


of  the  body  cavity  are  found  a  number  of  germ  cells,  which  develop  into 
individuals  of  the  next  generation. 

Swimming  about  in  the  water,  the  miracidium  seeks  out  certain  snails 
{Limud'a  trtiiicatnia,  L.  odliuensiH,  L.  rnhcUa),  which  it  immediately  attacks 
(Fig.  148).  The  miracidium  elongates  its  papilla  and  fastens  itself  to  the 
feelers,  head,  foot,  or  other  exterior  soft  portion  of  the  body  of  the  snail ; 


Fig.  151.— Iledia  of  tlie 
CO  111  111  on  liver  fluke 
{Fascio la  h]ep atica), 
containing  germinal 
cells  which  are  develop- 
ing into  cercariae.  xl50. 
(After  Leuckart,  1889, 
p.  269,  Fig.  129  A.) 


Fig.  152.— Eedia  of  the 
common  liver  fluke, 
with  developed  cerca- 
riae. X  150.  (After 
Leuckart,  1889,  p.  270, 
Fig.  180.) 


Fig.  153. — Free  cercaria 
of  the  coiiimon  liver 
fluke,  showing  two 
suckers,  intestine,  large 
glands,  and  tail.  (After 
Leuckart,  18H9,  p.  279, 
Fig.  187.) 


some  of  the  parasites  enter  the  pallial  (lung)  cavity  and  attach  themselves 
there.  After  becoming  securely  fastened  to  the  snail  the  miracidium 
discards  its  ciliated  covering,  and  shortens  to  about  half  its  former  length 
(0'07  mm.  to  0'08  mm.).  The  parasites  now  bore  their  way  into  the  body 
of  the  snail,  and  come  to  rest  in  the  liver  or  near  the  roof  of  the  pallial 
cavity,  etc. ;  the  movements  gradually  cease,  and  we  have  before  us  the 
stage  known  as  the — 

{(1)  Sporocyst  (Figs.  149  and  150). — The  eye-spots,  ganglionic  swellings, 
and  vestigial  intestine  become  more  and  more  indistinct,  and  are  finally 


biStOMATOSIS — LIVER    FLUKE    DLSEASfe^LIVER    ROT. 


^95 


lost.  The  sporocyst  grows  slowly  at  first,  then  more  rapidly,  and  at  the 
end  of  fourteen  days  or  so  measures  0*5  mm.  The  germ  cells  mentioned 
as  existing  in  the  posterior  portion  of  the  miracidium  now  develop  into 
individuals  of  a  third  generation,  known  as — 

(e)  lic'due  (Figs.  151  and  152). — The  redi?e  escape  from  the  sporocyst 
when  the  latter  are  from  two  weeks  (in  summer)  to  four  weeks  (in  late 
fall)  old.  Upon  leaving  the  body  of  the  sporocyst  they  wander  to  the 
liver  of  the  snail,  where  they  grow  to  about  2  mm.  long  by  0'25  mm. 
broad.  Each  redia  consists  of  a  cephalic  portion,  which  is  extremely 
motile,  and  which  is  separated  from  the  rest  of  the  young  worm  by  a 
ridge ;   under  the  latter  is  situated  an  opening,  through  which  the  next 


Fig.  154. — Portion  of  a  grass  stalk  with  three  encapsuled 
cercariae  of  the  common  liver  fluke  {Fasciola  kei^atica). 
X  10.     (After  Thomas,  1883,  p.  291,  Fig.  13.) 


■Xiffii^'... 


Fig.  155. — Isolated  en- 
cysted cercariaof  the 
common  liver  fluke. 
X  150.  (After  Leuc- 
kart,  1889,  p.  286, 
Fig.  142.) 


generation  (cercarise)  escape.  The  posterior  portion  of  the  worm  is  pro- 
vided, at  about  the  border  of  the  third  and  the  last  fourths  of  the  body, 
with  two  projections.  There  is  a  mouth  with  pharynx  situated  at  the 
anterior  extremity,  the  pharynx  leading  to  a  simple  blind  intestinal  sac. 
The  redia,  as  well  as  the  sporocyst,  may  be  looked  upon  as  a  female 
organism,  and  in  its  body  cavity  are  found  a  number  of  germ  cells,  which 
develop  into  individuals  of  the  next  generation,  known  as^ 

(/)  Cercance  (Figs.  153 — 155). — These  organisms  are  similar  to  the 
adult  parasites  into  which  they  later  develop.  The  body  is  flat,  more  or 
less  oval,  and  provided  with  a  tail  inserted  at  the  posterior  extremity. 
The  oral  sucker  and  acetabulum  are  present  as  in  the  adult,  but  the 
intestinal  tract  is  very  simple;  on  the  sides  of  the  body  are  seen  two 
large  glands,  but  the  complicated  genital  organs  of  the  adult  are  not 
visible,     The  cercaria  leaves  the  redia  through  the  birth  opening,  remains 


300 


DISEASES    OF   THE   LIVER. 


in  the  snail  for  a  longer  or  shorter  time,  or  passes  out  of  the  body  of  the 
snail  and  swims  about  in  the  water.  After  a  time  it  attaches  itself  to  a 
blade  of  grass  (Fig.  154)  or  some  other  object,  and  forms  a  cyst  around 
itself  with  material  from  the  large  glands,  at  the  same  time  losing  its 
tail.  It  now  remains  quiet  until  swallowed  by  some  animal.  Then,  upon 
arriving  in  the  stomach — of  a  steer,  for  instance  — the  cj^st  is  destroyed, 
and  the  young  parasite  wanders  through  the  gall-ducts  or,  as  some  believe, 


i^^-odi 


Fig.  156. — Drawing  fiora  a  microscopic  preparation,  showing  a  haemorrhage  in  the 
parenchyma  of  the  hver  caused  by  the  common  liver  fluke  {Fasciola  hepatica). 
a,  Atrophic  hver  tissue  ;  h,  round-cell  infiltration  ;  c,  a  portion  of  the  parasite ; 
d,  haemorrhage.     (After  Schaper,  1890,  PL  I.,  Fig.  1.) 


through  the  portal  veins  to  the  liver,  where  it  develops  into  the  adult 
hermaphrodite. 

From  the  above  we  see  that  this  parasite  runs  through  three  genera- 
tions, namely : 

(1.)  Ovum,  miracidium,  and  sporocyst     .     .     .     first  generation. 

(2.)  Redia     .     .     .     second  generation. 

(3.)  Cercaria  and  adult     .     .     .     third  generation. 

During  this  curious  development,  which  lasts  about  ten  to  twelve 
weeks,  there  is  a  constant  potential  increase  in  the  number  of  individuals, 
for  each  sporocyst  may  give  rise  to  several  (five  to  eight)  redijE,  each 
redia  to  a  larger  number  (twelve  to  twenty)  cercarise,  and  each  adult  to  an 


DISTOMATOSIS — LIVER   FLUKE   DISEASE — LIVER   ROT. 


301 


enormous  number  (37,000  to  45,000)  of  eggs.  This  unusual  fertility  of  the 
parasite  is  necessary  because  of  the  complicated  life  history  and  the  com- 
paratively small  chance  any  one  egg  has  of  completing  the  entire  cycle. 

Hosts.  An  interesting  and,  from  an  agricultural  standpoint,  an 
important  matter  connected  with  this  fluke  is  that  it  is  found  in  a  large 
number  (about  twenty-five)  of  domesticated  and  wild  animals,  and  this 


Fig.  157. — Drawing  from  a  microscopic  preparation,  showing  the  glandular  hyper- 
plasia of  the  mucosa  of  a  gall-duct  caused  by  the  common  liver  fluke  {Fasciola 
hepatica).  a,  Hypertrophied  submucosa  ;  b,  interstitial  connective  tissue;  c,  com- 
pressed lobule  ;  d,  lumen  of  the  gall-duct — thickened  fibrous  wall  of  the  gall-duct. 
(After  Schaper,  1890,  PI.  I.,  Fig.  2.) 

fact  probably  explains  to  some  degree  the  wide  geographical  distribution 
of  the  parasite. 

Symptoms.  The  symptomatology  of  this  disease  may  clinically  be 
divided  into  three  well-marked  periods : 

I.  Primary  period.  The  primary  phase  commences  with  the  pene- 
tration of  the  embryos  of  the  parasite  into  the  body,  firstly  into  the 
intestine,  and  then  into  the  liver  by  ascending  the  bile  ducts.  This  phase 
occurs  during  the  last  months  of  the  year,  October,  November,  and 
December,  and  is  rarely  accompanied  by  alarming  symptoms.  At  this 
time  the  sheep  appear  in  good  health,  the  summer  being  over,  and  the 


302 


DISEASES   OF   THE   LIVER. 


animals,  being  well  nourished  and  fat,  are  able  to  resist  the  first  attacks 
of  the  parasite,  so  that  even  an  observant  shepherd  only  notices  a  little 
dulness,  want  of  condition,  and  muscular  weakness.  It  requires  a  care- 
fully trained  eye  to  note  these  very  general  symptoms,  for  the  bodily 
condition  only  changes  very  slowly  and  progressively,  the  appetite  remain- 
ing good.  Experienced  butchers,  however,  in  the  districts  where  disto- 
matosis  is  common,  readily  detect  this  condition.  The  animals  make 
little  resistance  when  handled. 

Nevertheless,  even  in  this  primary  phase,  the  conditions  are  not  always 


C. 


Fig.  158. — Drawing  from  a  microscopic  preparation  showing  a  fluke  in  the  tissue  of 
the  liver,  a,  Necrotic  liver  tissue  ;  6,  atrophic  liver  cells  ;  c,  spines  on  the  fluke, 
showing  the  outline  of  the  body.     (After  Schaper,  1890,  PI.  III.,  Fig.  5.) 

as  above  sketched,  and  a  certain  number  of  deaths  may  occur.  Gerlach 
has  mentioned  the  possibility  of  death  by  cerebral  apoplexy,  in  conse- 
quence of  the  young  distomata  penetrating  to  the  brain.  Moussu  has 
certainly  never  seen  such  a  complication,  but  has  seen  death  from 
hepatitis,  perihepatitis,  and  secondary  pericarditis  in  animals  gravely 
infested.  The  young  embryos,  whether  they  penetrate  only  by  the  bile 
ducts,  as  has  been  stated,  or  are  carried  to  the  liver  by  the  blood  stream, 
often  excavate  canals  in  the  substance  of  the  gland  before  establishing 
themselves  in  the  bile  ducts.  They  make  their  way  as  far  as  Glisson's 
capsule,  and  may  even  penetrate  it ;  and  as  they  carry  with  them  innumer- 
able intestinal  germs,  when  they  arrive  rid  the  bile  ducts,  they  set  up 


DISTOMATOSIS — LIVER    FLUKE    DISEASE — LIVER   ROT. 


303 


hepatitis,  perihepatitis,  with  the  formation  of  numerous  false  mem- 
branes, or  even  infectious  fibrinous  peritonitis.  Should  the  patients  die 
during  this  phase  one  finds  young  distomata  at  the  surface  of  the  liver, 
or  even  in  the  thickness  of  the  false  membranes. 


Jan. 

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Fig.  159. — Tabular  diagrain  of  the  occurrence  of  the  common  liver  fluke  [Fasciola 
hepatica)  durmg  different  months  of  the  year,  a,  Cattle;  6,  sheep;  c,  swme. 
(After  Leuckart,  1889,  p.  301,  Fig.  147.) 


\Yhen  infestation  is  discrete  the  appearances  are  quite  different. 
Careful  breeders  have  even  stated  that  at  this  period  the  young  sheep 
appear  to  show  a  greater  tendency  to  fatten. 

II.  Second  period.     In  the  primary  phase  deaths  are  exceptional ;  they 


804 


DISEASES   OF   THE   LIVER. 


only  become  common  towards  the  end  of  the  winter.  During  the  second 
or  middle  period  (December  and  January)  the  patients  lose  flesh,  appear 
less  active,  show  less  regular  appetite  and  greater  thirst.  The  conjunctiva 
becomes  pale  and  swollen,  the  sclerotic  has  a  bluish  tint,  and  the  eyelids 
are  somewhat  infiltrated.  The  wool  appears  drier  and  less  curly ;  locks 
of  wool  part  readily  from  the  skin,  and  the  individual  fibres  become  dry 
and  fragile. 

This  phase  is  accompanied  by  very  marked  antemia,  rapid  exhaustion 
during  movement,  and  inability  to  run  for  any  length 
of  time. 

The  different  methods  of  examination  reveal 
nothing  specially  striking,  except  that  the  valvular 
sounds  of  the  heart  are  sharper,  and  that  trifling 
cedenia  occurs  under  the  thorax  and  abdomen. 

Microscopic  examination  of  the  faeces  reveals  the 
presence  of  eggs  of  distomata.  The  sheep  rapidly 
become  thin  from  about  the  end  of  January,  even 
although  the  appetite  persists  and  nourishing  food 
is  given. 

III.  Third,  or  wasting,  period.  The  decline, 
which  sets  in  about  February,  appears  extremely  ob- 
stinate, and  resists  all  treatment. 

The  patients  become  feeble,  eat  less,  and  digest 
badly.  Submaxillary  oedema,  common  to  advanced 
wasting  diseases,  then  appears.  If  the  sheep  are  re- 
moved from  the  fold  to  pasture,  the  swelling  of  the 
submaxillary  space  is  very  noticeable.  It  consists  in 
an  indolent  cedematous  tumefaction,  which  disappears 
when  the  animals  are  travelled,  but  reappears  when 
grazing  on  account  of  the  low  position  in  which  the 
head  is  then  held. 

The  condition  then  becomes  complicated  with 
diarrhoea,  and  soon  grows  alarming.  On  examination,  extensive  dropsy 
may  often  be  found  in  the  thorax,  pericardium,  and  abdomen. 

Death  results  from  exhaustion ;  the  animals  do  not  appear  to  suft'er, 
but  become  extraordinarily  antemic,  and  perish  without  a  struggle.  The 
blood  is  simply  rosy  in  colour,  like  gooseberry  syrup :  the  clot  is  soft 
and  gelatinous :  the  number  of  red  blood  corpuscles  has  fallen  from 
about  seven  millions  to  a  few  hundred  thousand. 

Icterus  is  rare,  though  certain  cases  have  been  described  where  it  has 
appeared  during  the  last  and  even  during  the  middle  stage. 

When  animals  begin  to  die  in  a  district  which  has  long  been  infested, 
the  losses  are  enormous,  the  condition  sometimes  constitutes  a  perfect 


Fig.  160.— The  large 
American  fluke 
{Fasciola  magna), 
natural  size. 
(Stiles,  Annual 
Eeport,  U.S.A. 
Bureau  of  Agricul- 
ture, 1901.) 


DISTOMATOSIS — LTVER    FLUKE   DISEASE — LIVER   ROT. 


305 


scourge.  It  should  be  remarked,  however,  that  all  those  affected  do  not 
die ;  anmials  kept  under  good  conditions  may  even  survive  for  several 
months,  although  greatly  wasted. 

Towards  March  and  April  the  parasites  leave  their  position,  and  are 
conveyed  by  the  current  of  bile  towards  the  intestine,  to  be  rejected 
with  the  faeces.  This  is  the  period  of  convalescence  and  recovery;  but 
recovery  is  only  relative,  for  the  parasites  are  never  entirely  evacuated. 
The  distomata  then  recommence  their 
life  cycle  outside  the  animal  body. 

Unfortunately  the  mortality  caused  by 
distomata  is  accidentally  aggravated  by 
other  diseases,  and  the  scourge  then  be- 
comes an  absolute  disaster  for  the  dis- 
tricts where  such  complications  occur. 
Thus  Besnoit  and  Cuille,  of  Toulouse 
have  shown  that  distomatosis  may  be- 
come complicated  with  a  form  of  very 
rapidly  fatal  haemorrhagic  septicaemia, 
produced  by  an  ovoid  bacterium. 

Distomatosis,  already  sufficiently 
grave,  then  becomes  infinitely  more 
serious,  if  only  from  the  fact  that  it 
may  prove  the  point  of  origin  of  an 
absolutely  fatal  complication. 

In  bovine  animals  the  symptoms  de- 
velop exactly  as  in  sheep,  though  the 
cachectic  period  is  uncommon  and  the 
injury  done  is  often  less  important  than 
in  sheep.  The  patients  exhibit  irregular 
appetite,  wasting  without  appreciable 
cause,  anaemia,  and  even  diarrhoea.  In 
spite  of  excellent  winter  feeding  they 
do  not  regain  condition,  and  relative  re- 
covery only  sets  in  with  the  approach  of  spring.  Death  from  simple 
distomatosis  is  exceptional,  but  in  animals  so  predisposed  enteritis  de- 
velops more  easily,  as  do  all  forms  of  infection  of  intestinal  origin. 

The  disease  is,  however,  also  grave  for  bovines  because  successive 
reinfection  occurs,  and  the  disease  may  be  prolonged  for  years. 

Causation.     Distomatosis  is  due  to  one  cause,  viz.,  the  entrance  of 
embryo  flukes  into  the  digestive  apparatus  of  herbivora. 

The  adult  distomata  in  the  biliary  ducts  continually  discharge  large 

quantities  of  eggs,  though  the  process  is  most  active  between  February 

and  June  or  July.     The  eggs  are  carried  away  with  the  bile  and 

D.c.  X 


Fig.  161. — Macerated  specimen 
of  large  American,  fluke,  show- 
ing the  digestive  system  and 
acetabulum.  X  2.  (After  Stiles, 
1894,  p.  226,  Fig.  2.) 


306 


DISEASES    OF   THE    LtVElt. 


and  pass  on  to  the  pastures,  where  they  continue  then-  Hfe  cycle,  thanks 
to  moisture  and  the  presence  of  stagnant  water.  The  embryos,  having 
escaped  from  the  egg,  enter  the  bodies  of  the  snails  found  in  or  near 
stagnant  water  {Limnaa  truncatida),  become  converted  into  sporocysts, 
and  afterwards  into  rediaj  and  cercariae.  The  cercarise  become  encysted 
on  the  lower  surface  of  blades  of  grass  in  damp  pastures,  whence  they 
are  transferred  to  the  animals'  stomachs  along  with  the  grass  itself. 

As  the  LivDuea  truncatida  lives  not  only  in  marshy  regions,  but  also 
in  all  damp  situations,  the  embryos  of  distomata  are  distributed  over 
enormous  areas,  and  the  disease  itself  is 
equally  widespread.  The  embryo,  after  in- 
gestion, is  set  at  libert}^,  and  passes  from  the 
intestine  into  the  innermost  recesses  of  the 
liver,  being  guided  up  the  bile  ducts  by 
the  current  of  bile.  At  this  point  it  attaches 
itself  to  the  wall  of  the  bile  duct,  passes 
through  its  various  stages  of  evolution,  and 
attains  the  adult  form.  It  then  begins  lay- 
ing eggs,  and  thus  starts  a  new  evolutionary 
cycle. 

The  life  cycle  of  Distoma  lanceolatnm  is 
not  yet  known,  and  this  variet}^  moreover, 
is  less  widely  distributed  than  the  Distoma 
liepaticum. 

The  bile  ducts  are  more  easily  pene- 
trated by  the  distoma  in  young  animals,  a 
fact  which  explains  why  calves  and  lambs 
are  particularly  affected.  Adults  present  a 
less  favourable  nidus,  a  fact  which  renders 
them  less  easily  infected,  but  does  not  en- 
tirely prevent  the  parasites  from  attacking 
them.  Old  animals,  although  unable  to  resist  entirely,  seldom  harbour 
many  of  the  parasites. 

Wet  years  appear  to  favour  the  extension  and  propagation  of  dis- 
tomatosis  in  an  extraordinary  fashion,  a  fact  which  is  easily  understood, 
if  we  regard  the  phases  of  evolution  of  the  parasite.  The  autumn  appears 
particularly  favourable  to  the  infection  of  herds.  This  is  explained  by 
the  fact  that,  during  the  summer,  the  dryness  of  the  fields  entirely  pre- 
vents the  development  of  such  eggs  as  may  be  distributed  over  them  ; 
whilst  wet  periods  during  the  autumn  favour  this  development. 

On  the  other  hand,  the  grass  becomes  eaten  down  in  autunni,  so  that 
the  animals  gather  it  almost  level  with  the  ground.  As  the  cercariae 
attach  themselves  to  the  lowest  leaves  they  are  then  ingested  in  much 


Fig.  162. — Limncca  trunca- 
tula.  Natural  size  and  mag- 
nified.    (After  Railliet.) 


DISTOMATOSIS — LIVER    FLUKE   DISEASE — LIVEU   ROT.  307 

larger  quantities.  The  bad  effects  of  wet  seasons  are  not  immediately 
apparent,  but  appear  during  the  following  spring. 

Distomatosis  is  common  throughout  almost  the  whole  of  Europe, 
Africa,  and  America.  In  France  it  is  most  serious  in  the  moister 
regions  of  Sologne,  in  Berry,  the  mountainous  and  wet  districts  of  the 
great  central  plateau,  and  particularly  in  the  Pyrenees.  It  particularly 
attacks  oxen  in  the  valley  of  the  Meuse,  the  marshes  of  Picardy,  the 
lower  regions  of  Normandy,  and  in  aril  the  mountainous  pastures  of  the 
central  plateau. 

Lesions.  The  lesions  of  distomatosis  vary  with  the  stage  of  develop- 
ment of  the  parasites.  During  the  primary  phase  of  invasion  of  the 
bile  ducts  by  young  distomata  one  finds  interstitial  diffuse  hepatitis,  due 
to  perforation  of  the  gland  by  young  parasites,  adhesive  perihepatitis, 
with  the  formation  of  false  membranes,  and  not  uncommonly  slight 
peritonitis. 

Zoologists  state  that  the  young  distomata  penetrate  the  liver  by 
passing  upwards  against  the  current  of  bile.  It  does  not  appear  impos- 
sible, however,  that  they  may  penetrate  by  another  path,  particularly  as 
so-called  "erratic"  forms  of  distomatosis  like  distomatosis  of  the  lung, 
heart,  lymphatic  glands,  and  various  other  tissues  are  not  uncommon. 
It  has  been  suggested  that  the  young  distomata,  arriving  in  the  bile 
ducts,  perforate  the  gland,  giving  rise  to  these  lesions  of  perihepatitis, 
peritonitis  or  erratic  distomatosis  ;  but  this  view  is  scarcely  in  harmony 
with  the  fact  that  the  parasites  are  usually  found  in  the  bile  ducts. 

During  the  second  phase,  corresponding  to  the  development  of  almost 
adult  distomata,  the  perihepatitis  and  peritonitis  set  up  either  produce 
fatal  results  by  secondary  infection  or  diminish  and  disapi^ear.  The 
parasites  develop  in  the  bile  ducts,  in  which  they  attain  the  adult  con- 
dition. They  steadily  ascend  towards  the  origins  of  the  ducts,  dilating 
them  in  their  passage  in  an  extraordinary  way.  The  number  of  para- 
sites varies  greatly  :  sometimes  there  are  but  few,  and  they  are  only 
discovered  on  post-mortem  examination ;  in  other  cases  the  bile  ducts  are 
crammed  with  them,  as  many  as  six  or  seven  hundred  or  even  a  thousand 
being  present.  The  distended  bile  ducts  always  show  chronic  peripheral 
inflammation,  which  steadily  becomes  aggravated,  producing  pericanali- 
cular atrophying  sclerosis.  This  condition  is  followed  by  change  in  and 
disappearance  of  a  certain  quantity  of  hepatic  tissue,  and  by  various 
forms  of  vascular  and  secretory  disease. 

This  is  the  period  of  greatest  disturbance,  not  only  in  consequence  of 
the  actual  presence,  but  also  of  the  mode  of  living,  of  the  parasites. 

Moussu  declares  that  the  parasites  live  principally  on  blood,  at  least 
during  the  first  and  second  stage  of  their  sojourn  in  the  liver,  adducing 
as  proof  that  if  one  completely  injects  the  vascular  system  of  the  liver 

X  2 


308  DISEASES   OF   THE    LIVER. 

(arteries  and  veins),  some  of  the  injected  matter  ^Yill  be  found  a  day 
afterwards  in  the  digestive  apparatus  of  the  parasites. 

The  disturbances  which  they  produce  are  therefore  due  to  their 
actual  presence  and  its  consequences,  to  their  mode  of  life,  and  to  the 
intercurrent  infections  of  which  they  are  sometimes  the  initial  cause. 

It  is  idle  to  object  that  the  part  played  by  these  parasites  is  less 
important  than  has  been  suggested,  and  that  the  mortality  results  from 
intercurrent  infection,  and  not  from  the  parasites  themselves.  It  is 
equally  idle  to  point  out  that  carcases  of  animals  suffering  from  severe 
infection  with  distomata,  particularly  the  carcases  of  sheep,  are  frequently 
found  in  slaughter-houses,  in  perfectly  fat  condition,  and  with  the  appear- 
ance of  not  having  suffered  in  any  way.  These  observations  are  perfectly 
correct  and  well  founded.  But  it  matters  little  that  death  results  from 
an  infection  superadded  to  the  distomatosis,  if  the  presence  of  distomata  is 
the  determining  factor  in  causing  the  superadded  infections,  and  if  such 
infection  is,  as  Moussu  believes,  almost  inevital)le  in  animals  already 
exhausted  by  the  action  of  the  parasites. 

The  fact  that  animals  suffering  from  distomatosis  and  slaughtered  for 
food  are  well  nourished  is  not  a  valid  objection  ;  for  it  has  long  been 
known  that  wasting  and  anaemia  are  not  immediate  consequences,  and 
that  before  they  are  clearly  apparent  the  distomata  must  have  been 
present  in  the  liver  for  several  months.  Bakewell  and  the  Marquis 
of  Behague  have  shown  that  in  moderately  infected  animals  there  is 
a  tendency  to  lay  on  flesh  during  the  first  and  a  portion  of  the  second 
of  development  of  the  disease. 

If  the  animals  are  slaughtered  before  the  period  of  progressive 
decline  sets  in,  it  is  quite  possible  to  form  entirely  wrong  views  regard- 
ing the  importance  of  these  parasites. 

The  wasting  process  commences  towards  the  end  of  the  second  phase 
of  the  disease,  and  then  makes  rapid  progress.  The  parasites,  which 
have  then  been  continuously  drawing  on  the  blood  for  their  nourishment 
for  a  long  time,  produce  anemia,  and  some  infection  of  the  bile  ducts, 
and  usually  a  certain  degree  of  icterus. 

The  third  phase  is  accompanied  by  general  signs  of  cachexia,  which 
need  not  again  be  described.  They  are  similar  to  those  of  all  pro- 
crressive  cachexias.  In  animals  which  survive  this  phase  and  are 
ultimately  slaughtered  the  liver  always  shows  very  marked  sclerosis, 
commencing  around  the  biliary  ducts.  Even  after  the  parasites  have 
been  evacuated,  these  ducts  appear  indurated,  thickened,  fibrous,  and 
sometimes  encrusted  with  biliary  deposits  or  obstructed  with  true  calculi. 
These  calculi  may  or  may  not  contain  parasites ;  sometimes  they  simply 
contain  e^o's  :  they  are  open,  tubular,  and  perforated,  but  always  irregular 
on  the  surface. 


DISTOMATOSIS — LIVER    FLUKE    DISEASE — LIVER    ROT,  309 

When  in  addition  complications  have  appeared,  one  usually  finds 
general  lesions  of  septicaemia  and  blood  infection. 

In  erratic  distomatosis,  which  is  of  no  importance  clinically,  disto- 
mata  may  become  encysted  in  the  lung  or  other  viscus,  and  in  time 
die.  The  cysts,  which  only  contain  one  and  rarely  two  parasites, 
present  a  fibrous  shell,  enclosing  a  blackish,  pultaceous,  grumous 
magma,  which  sometimes  has  undergone  a  certain  amount  of  calcareous 
infiltration.     The  parasite  may  be  entirely  destroyed. 

Diagnosis.  Early  diagnosis  is  difficult,  and  can  only  be  established 
by  microscopic  examination  of  the  excreta  and  the  discovery  of  eggs. 
On  an  average  one  may  find  one  egg  in  each  preparation  when  the 
liver  contains  80  to  100  flukes.  When  wasting  is  very  marked,  and 
particularly  when  there  has  already  been  a  number  of  deaths,  diagnosis 
becomes  extremely  easy.  It  is  sufficient  to  find  flukes  in  any  form 
{Distoma  hepaticum  vcl  lanceolafnm)  to  be  assured  as  to  the  cause  of 
disease. 

Prognosis.  In  severely  infested  cases  the  prognosis  is  extremely 
grave,  because  no  efficient  method  of  treatment  exists.  Embedded 
in  the  liver,  the  parasites  resist  the  action  of  all  drugs,  and  we  know 
of  no  anthelmintic  eliminated  hy  the  bile  which  in  any  way  affects 
their  vitality.  When  the  disease  is  recognised  early,  the  most  econo- 
mical method  is  to  fatten  the  animals  as  rapidly  as  possible  and 
prepare  them  for  slaughter. 

Treatment.  There  is  no  reliable  curative  treatment.  The  drugs 
which  one  might  employ  would  kill  the  animal  before  poisoning  the 
parasites  embedded  in  the  liver.  Various  mixtures  containing  sulphate 
of  iron,  juniper  leaves,  etc.,  have  been  recommended ;  but  rich  food 
constitutes  the  best  of  all  treatment,  both  from  a  curative  and  a  pro- 
phylactic standpoint. 

With  the  view  of  preventing  the  disease,  however,  and  protecting 
flocks  from  attack  in  places  where  the  disease  is  common,  certain 
precautions  should  be  adopted.  They  comprise — {a)  providing  a  free 
supply  of  rock-salt,  either  in  masses  placed  in  the  mangers  or  dis- 
tributed with  the  food ;  the  salt  increases  gastric  secretion,  and  has 
a  slight  action  on  the  parasites :  {h)  adding  to  the  food  during  the 
first  months  of  winter  branches  of  birch,  juniper,  willow,  and  broom ; 
the  leaves  of  these  plants  contain  aromatic  or  resinous'  principles 
which  act  on  the  liver,  are  eliminated  by  the  bile,  and  may  have 
valuable  results. 

But  of  all  preventive  measures  the  most  efTective  consist  in  draining, 
cleansing,  and  drying  low,  moist,  or  marshy  lands,  because  the  molluscs 
which  are  essential  to  the  life  cycle  of  the  parasites  are  unable  to 
develop  where  the  soil  is   dry.      The   manure  containing  the  eggs  of 


310  DISEASES    OF   THE    LIVER. 

the  parasites  may  be  disinfected  by  adding  to  it  lime,  sulphate  of  iron, 
or  common  salt.  Common  salt  and  lime  spread  over  the  pastm-es 
has  a  double  beneficial  influence,  acting  both  as  a  manure  and  as  a 
parasiticide.  From  May  to  August  is  the  l)est  time  for  spreading 
this  dressing. 

The  fluke  embryos  are  destroyed  by  1  to  2  per  cent,  solutions  of 
common  salt,  and  by  f  per  cent,  solutions  of  lime. 

In  over-stocked  fields  the  animals  are  obhged  to  graze  very  close 
to  the  ground,  and  are  thus  more  exposed  to  infection.  Over-stocking 
should  therefore  be  avoided.  Animals  should  not  be  left  too  long  on 
the  same  ground.  If  infected  they  should  at  once  be  driven  to  higher 
pastures.  Eaised  water  tanks  can  be  placed  in  the  pastures — they  are 
less  likely  to  become  infected.  Animals  from  known  infected  flocks 
or  herds  should  not  be  purchased.  Livers  from  infected  animals 
should  be  cooked  or  destroyed.  If  eaten  raw  by  dogs  the  eggs  pass 
uninjured  through  the  dog's  intestine  and  infect  fresh  pastures. 

Sulphate  of  iron  distributed  in  quantities  of  250  to  400  lbs.  per 
acre  is  valuable  as  a  manure,  and  would  probably  have  a  greater 
eft'ect  in  destroying  the  embryos. 


SECTION    III. 

RESPIRATORY    APPARATUS, 

CHAPTER     I. 

EXAMINATION    OF    THE    RESPIRATORY    APPARATUS. 

From  the  clinical  standpoint  a  study  of  the  respiratory  apparatus 
implies  the  examination  of  the  nostrils,  nasal  cavities,  frontal  and 
maxillary  sinuses,  larynx,  trachea,  and,  for  the  purpose  of  ascertain- 
ing the  condition  of  the  lungs  and  pleura,  of  the  chest. 

Nasal  cavities.  Examination  of  the  external  portion  of  the  nasal 
cavities  is  extremely  simple.  The  observer  notes  the  degree  to  which 
the  orifices  are  dilated,  the  frequency  of  the  respiratory  movements 
and  the  condition  of  the  muzzle.  He  may  find  various  eruptions, 
crusts  due  to  discharge,  etc.,  and  will  remark  any  peculiarities  pre- 
sented by  these.  The  depths  of  the  nasal  cavities  can  only  be  examined 
through  the  nostrils  to  a  very  limited  extent ;  but  the  condition  of  the 
pituitary  mucous  membrane,  its  degree  of  vascularity,  and  the  exist- 
ence of  ulcerations  or  of  vegetations  can  be  observed. 

Digital  examination  is  sometimes  useful  in  discovering  the  condition 
of  the  lower  portions  of  the  turbinated  bones.  The  electric  light  does 
not  greatly  assist  the  observer,  on  account  of  the  narrowness  of  the 
air  passages.  On  the  other  hand,  examination  of  the  face,  and  pal- 
pation and  percussion  over  the  region  of  the  frontal  sinuses  is  of 
considerable  value.  By  inspection,  one  discovers  deformity  caused  by 
tumours,  by  ossific  inflammation,  or  other  lesions ;  and  detection  is 
rendered  easier  by  the  fact  that  deformities  are  usually  asymmetrical, 
only  occurring  on  one  side. 

Palpation  reveals  the  degree  of  resistance  and  flexibility  of  the 
external  bony  wall  as  well  as  the  condition  of  the  subcutaneous 
tissues. 

Percussion  sometimes  discloses  absolute  dulness,  due  to  tumours  of 
the  mucous  membrane,  of  the  turbinated  bones,  or  of  the  bones  of 
the  face. 

The  pharyngeal  portion  of  the  nasal  cavities  is  difficult  to  reach, 


312 


RESPIRATORY   APPARATUS. 


but  can  be  examined  by  jiassing  the  hand,  pahn  upwards,  into  the 
pharyngeal  cavity,  when  the  fingers  may  be  slipped  behind  the  soft 
palate  and  thus  introduced  into  the  posterior  nasal  chamber.  The 
animals  should  first  be  very  carefully  secured  and  a  strong  gag  intro- 
duced into  the  mouth. 

Sinuses.  Frontal  sinus. — The  frontal  sinus  occupies  the  greater 
part  of  the  anterior  cranial  region  and  the  summit  of  the  head,  ex- 
tending from  the  highest  point  of  the  poll  as  far  forward  as  a  line 
drawn  between  the  two  orbits.  Above,  it  directly  communicates  with 
the  sinus  of  the  horn  core.  In  this  upper  region,  where  it  abuts  on 
the  sinus  of  the  opposite  side  along  the  median  line,  it  is  of  greatest 


Fig.  163. — Median  section  through  an  ox's  head.  Sf,  Frontal  sinus;  N.Ph.  naso- 
pharnyx;  Vp.,  hard  palate  ;  C,  turbinated  bones  ;  V.,  vomer;  L.,  tongue;  V.  pa., 
soft  paUite  ;  E.,  epiglottis  ;  La.,  larynx  ;   ffi.,  oesophagus. 


size.  Below,  on  the  other  hand,  it  is  very  narrow,  much  broken  up 
and  incompletely  divided  into  a  series  of  cells,  by  thin,  bony  plates 
running  in  all  directions. 

It  is  in  direct  communication  with  the  nasal  cavity. 
The  frontal  sinus,  then,  occupies  all  the  supero-lateral  portion  of 
the  cranial  box,  which  is  thus  provided  with  a  double  wall.  At  one 
point,  however,  over  a  lozenge-shaped  area,  the  cranial  cavity  is  only 
protected  by  a  single  wall.  It  is  in  this  region  that  the  slaughter- 
man strikes  the  animal  when  killing  it. 

The   frontal    sinus    may  be  examined  ])y  inspection  and  palpation, 


EXAMINATION    OF   THE    RESPIRATORY   APPARATUS. 


313 


Inspection  sometimes  reveals  deformity  of  the  external  wall  of  the 
sinus.  Such  deformity,  however,  is  rare,  and  Moussu  has  only 
observed  it  in  two  cases  of  tuberculosis  of  the  bones  forming  the 
cranial  wall. 

By  percussion  one  detects  abnormal  sensibility,  and  partial  or  com- 
plete dulness  over  certain  areas. 

MaxiUarif  sinus.— The   maxillary  sinus   occupies  the    whole  lateral 


Fig.  164. — General  arrangement  of  the  sinuses.     The  circular  openings  indicate 
points  at  which  trepanation  is  performed. 


region  of  the  face,  from  the  inferior  extremity  of  the  maxillary  spine 
as  far  as  the  sub-orbito-palatine  region.  In  front  its  external  wall 
is  very  solid,  but  behind,  below  the  orbit,  is  extremely  thin.  Ex- 
ternally the  sinus  is  largely  protected  by  the  anterior  insertion  of  the 
external  masseter  muscle,  a  fact  which  explains  how  rarely  it  is 
injured. 

Larynx,     In   consequence   of    its   deep    situation,    the    larynx    can 


314 


RESPIRATORY    APPARATUS. 


Bcarcely  be  examined  except  by  inspection,  external  palpation,  internal 
digital  palpation,  and  auscultation. 

External  examination  presents  no  difficulty,  and  enables  one  to  detect 
lesions  around  or  near  tbe  larynx. 

Palpation  reveals  the  existence  of  cedematous  swellings,  enlarge- 
ments of  the  retro-pharyngeal  lymphatic  glands,  inflammatory  en- 
gorgements, etc. 

Internal  digital  examination,  like  examination  of  the  pharynx,  can 
only  be  performed  after  very  firmly  fixing  the  animal  in  position,  and 
inserting  a  gag  in  the  mouth. 

The  hand  is  introduced,  palm  downwards,  and  passed  as  far  as  the 


Fig.  165. — Manual  examination  of  the  larynx  in  the  ox. 


pharyngeal  cavity.  The  index  finger  can  then  easily  be  slipped  into 
the  glottis.  Exploration  must  be  effected  rapidly  and  without  violence. 
It  reveals  the  condition  of  the  glottis,  the  presence,  position  and  form 
of  growths  like  myxomata  and  of  new  tissues,  due  to  the  presence  of 
actinomyces,  as  well  as  tuberculous  vegetations  or  ulcerations. 

By  auscultation  we  discover  the  presence  of  normal  or  abnormal 
laryngeal  sounds — roaring,  whistling,  or  bubbling  sounds,  etc. 

Trachea.  The  trachea  may  be  examined  by  palpation  and 
auscultation. 

Palpation  reveals  the  degree  of  sensitiveness,  abnormalities  in  position 
or  form,  the  presence  of  peripheral  inflammations,  fractures  of  rings,  etc. 

Auscultation  indicates  whether  the  tracheal  sound  be  normal  or 
otherwise,  or  accompanied  by  abnormal  sounds,  like  mucous  rdh's,  or 
by  pathological  sounds  conveyed  from  the  chest. 


EXAMINATION    OF   THE    RESPIRATORY   APPARATUS.  315 

Thorax.  The  thorax  can  he  examined  hy  inspection,  palpation, 
percussion,  and  auscultation. 

By  inspection  we  discover  whether  the  formation  of  the  thorax 
as  a  whole  is  normal,  or  whether  there  exist  congenital  or  acquired 
deformities,  asymmetry  like  that  produced  by  pneumo-thorax  or  devia- 
tions of  ribs  from  the  normal  line,  etc.  One  also  notes  the  breathing 
movements,  the  manner  in  which  the  sides  expand  and  contract,  the 
respiratory  rhythm,  and  any  special  peculiarities  of  inspiration  or 
expiration. 

Palpation  reveals  the  degree  of  sensitiveness  of  the  thoracic  wall  and 
of  the  intercostal  spaces,  the  existence  of  more  or  less  extensive  local 
cedematous  infiltration,  and  the  presence  or  disappearance  of  thoracic 
conditions  like  hydro-thorax. 

Percussion  indicates  the  degree  of  sonority  of  the  chest  in  different 
parts.  It  can  either  be  practised  directly  with  the  hand  or  through  the 
medium  of  a  pleximeter.  The  latter  method  is  preferable  when 
dealing  with  fat  animals.  Percussion,  however,  gives  slightly  different 
results,  according  to  the  degree  of  fatness  of  the  subjects.  It  should  be 
practised  both  in  a  vertical  as  well  as  in  a  horizontal  direction. 

At  all  points  where  the  muscles  are  thick  or  well  developed  the  results 
produced  are  negative,  in  the  sense  that  only  a  dull  sound  is  obtained. 
This  is  the  result  obtained  in  auscultating  the  areas  marked  1,  where 
one  meets  with  the  ileo-spinal  and  common  intercostal  muscle,  and  in 
that  marked  i,  where  the  olecranian  muscles  are  encountered  (Fig.  166). 
Over  the  middle  and  inferior  zones,  however,  the  results  are  much  more 
instructive. 

On  the  right  side  percussion  of  the  middle  zone  gives,  under  normal 
conditions,  a  clear  sound  and  perfect  resonance  from  above  doM-nwards, 
and  from  in  front  backwards,  between  the  fourth  intercostal  space  and 
the  ninth  rib.  Beyond  this  point  lies  the  liver,  which  gives  a  partial 
dull  sound,  and  absolute  dulness  from  the  ninth  to  the  twelfth  rib,  in 
consequence  of  its  position,  and  of  the  projection  of  the  diaphragm 
towards  the  thoracic  cavity. 

Percussion  of  the  inferior  zone  produces  less  marked  resonance,  which 
diminishes  more  and  more  towards  the  base,  in  consequence  of  the  thin- 
ness of  the  pulmonary  lobes  at  this  point.  This  resonance  does  not 
extend  as  far  as  the  hypochondriac  region,  because  the  lower  part  of  the 
abomasum  insinuates  itself  beneath  the  costal  cartilages  and  causes  a 
region  of  dulness. 

On  the  left  side  percussion  gives  precisely  similar  results,  except 
in  the  upper  portion  of  the  middle  zone.  Beyond  the  ninth  inter- 
costal space  the  sound  changes,  and  has  a  tympanic  character;  because 
here  the  anterior  and  upper   portions  of  the  rumen  are  encountered, 


316  RESPIRATORY   APPARATUS. 

as  they  are  lodged  beneath  the  hypochondrium.  Below,  the  sound  is 
dull,  on  account  of  the  gastric  compartments  generally  being  full  of 
food. 

Certain  trifling  modifications  of  this  normal  condition  may  be  noted, 
depending  on  the  degree  of  fatness  or  thinness  of  the  subjects.  The 
pathological  changes  which  may  occur  are  as  follows  : — 

A  tympanic  sound,  with  or  without  metallic  character,  may  be  found 
at  a  point  where  normally  one  would  expect  a  clear  sound  (pneumo- 
thorax, diaphragmatic  hernia).  A  dull  sound  may  be  met  with  in  the 
same  regions,  all  resonance  being  lost  (pneumonia,  broncho-pneumonia, 
pleural  exudate,  etc.).  Partial  dulness  and  partial  loss  of  resonance  may 
occur  in  regions  which  ought  to  give  a  resonant  sound  (deep  pneumonia, 
tuberculous  lesions,  the  presence  of  echinococcus  cysts,  etc.). 

Auscultation — i.e.,  examination  by  means  of  the  ear — is  the  most 
valuable  method  of  discovering  and  localising  pulmonary,  pleural,  or 
cardiac  lesions. 

Various  sensations  are  conveyed  to  the  ear,  depending  on  the  method 
in  which  the  normal  or  pathological  sounds  are  produced. 

The  deductions  to  be  drawn  as  regards  the  nature  of  existing  disease 
are  based  on  the  intensity,  character,  duration,  and  special  attributes  of 
the  sounds  noted. 

Direct  auscultation  is  the  most  certain  method,  but  the  ear  cannot  be 
applied  with  equal  facility  at  all  points.  Under  such  circumstances 
a  simple  or  binaural  stethoscope,  or  the  phonendoscope,  may  be  used 
with  advantage. 

To  properly  appreciate  the  sounds  heard  it  is  essential  to  be  exactly 
acquainted  with  the  relation  between  the  lung  and  thorax.  On  the  left 
side  (Fig.  60)  the  anterior  pulmonary  lobe  occupies  the  space  between 
the  first  and  fourth  ribs,  in  front  and  above  the  base  of  the  heart.  The 
middle,  or  cardiac,  lobe  covers  the  left  upper  and  postero-lateral  part 
of  the  heart  from  the  fourth  to  the  sixth  rib.  The  posterior  lobe 
occupies  all  the  region  beyond  the  sixth  rib  as  far  as  the  twelfth. 

On  the  right  side  the  arrangement  is  similar,  but  the  anterior  lobe 
and  the  cardiac  lobe  are  more  developed  (Fig.  62), 

Under  ordinary  circumstances  the  extensive  movement  of  the  lung 
which  occurs  during  inspiration  produces  a  special  sound  known  as  the 
respiratory  or  vesicular  murmur.  Contrary  to  what  has  been  written, 
and  said,  this  sound  in  animals  possessing  absolutely  sound  lungs  ends 
with  inspiration.  Expiration  is  silent,  though  it  is  easy  to  estimate 
its  duration. 

In  auscultating  the  lung,  we  may  distinguish  four  zones,  a  superior 
zone,  a  middle  zone,  an  inferior  zone,  and  a  scapular  zone. 

The  superior  zone  is  bounded  by  the  vertebro-costal  gutter,  descends 


EXAMINATION   OF   THE   RESPIRATORY   APPARATUS.  317 

approximately  as  far  as  the  inferior  line  of  insertion  of  the  common 
intercostal  muscle,  and  extends  from  the  summit  of  the  scapula  in  front 
to  the  hypochondrium  behind. 

Auscultation  of  this  region  through  the  ileo-spinal  and  common 
intercostal  muscle  will  always  reveal,  except  in  very  fat  animals,  the 
vesicular  murmur  to  a  point  as  far  back  as  the  eleventh  intercostal 
space.  Nevertheless,  this  vesicular  murmur  is  relatively  feeble,  and 
becomes  imperceptible  beyond  the  eleventh  rib. 

The  middle  zone  comprises  the  most  convex  portion  of  the  ribs,  and 
at  this  point  the  wall  of  the  thorax  is  thinnest,  while  the  lung  below 
is  thickest. 

For  these  reasons  the  vesicular  murmur  is  heard  at  its  maximum 


Fig.  166. — The  areas  over  which  auscultation  of  the  chest  may  be  performed, 
showing  their  extent,  position  and  relations  to  the  thoracic  wall.  1,  Upper 
zone  ;  2,  middle  zone  ;  3,  inferior  zone  ;  4,  subscapular  zone. 

intensity  at  this  point.  Towards  the  upper  and  lower  limits  of  this  zone 
are  found  the  great  bronchial  divisions,  so  that  auscultation  should 
always  be  practised  with  the  greatest  care  at  this  point.  The  middle 
zone  occupies  approximately  one-third  of  the  total  depth  of  the  thorax. 
The  vesicular  murmur  becomes  weaker  as  one  passes  backwards,  and 
finally  disappears  at  a  considerable  distance  from  the  angle  of  the 
hypochondrium,  following  a  curved  line  the  convexity  of  which  is 
directed  forwards,  and  which  is  continuous  with  that  limiting  the 
upper   zone. 

These  peculiarities  are  due  to  the  anatomical  arrangement  and 
mode  of  insertion  of  the  diaphragm  on  the  internal  surface  of  the 
hypochondrium . 


318  RESPIRATORY    APPARATUS. 

The  inferior  zone  is  very  limited,  and  corresponds  externally  to  the 
inferior  third  of  the  thorax,  and  topographically  to  the  cardiac  lohe  or 
middle  lohe  of  the  lung  and  to  the  inferior  portion  of  the  posterior  lobe. 

As  these  pulmonary  lobes  are  of  comparatively  slight  thickness,  the 
vesicular  murmur  is  feeble.  It  can  be  heard  over  a  trapezoidal  space, 
forming  a  jirolongation  of  the  middle  zone,  but  not  below  in  the  region 
of  the  sternum  or  pectoral  muscles. 

The  fourth  zone  extends  over  the  mass  of  the  olecranian  muscles. 
It  is  of  triangular  form,  in  consequence  of  the  inclination  of  the  scapula 
and  humerus.  Except  in  very  fat  animals  the  vesicular  murmur  is 
readily  audible  through  the  muscular  mass  on  the  right  side  l)etter  than 
on  the  left,  on  account  of  the  development  of  the  right  anterior  pul- 
monary   lobe. 

On  the  left  side  the  beating  of  the  heart  is  heard  al)ove  the 
pulmonary  sounds. 

Clinically  one  may  hear  an  exaggeration  of  the  ordinary  respiratory 
murmur  whenever  the  lung  is  actively  exercised,  as,  e.t/.,  immediately 
after  trotting.  This  exaggeration,  however,  is  often  pathological.  It  is 
known  as  "  juvenile  or  supplementary  respiration,"  when  due  to  the 
fact  that  some  other  portion  of  the  lung  is  not  acting. 

The  respiratory  murmur  may  be  lessened  in  certain  morbid  con- 
ditions, such  as  emphysema  and  congestion  of  the  lung,  and  may  com- 
pletely disappear  in  pneumonia  or  broncho-pneumonia,  a  fact  which 
is  even  of  greater  significance. 

In  various  jDathological  conditions  the  respiratory  murmur  may  also 
be  modified.  On  the  other  hand,  the  movement  of  air  in  the  bronchi 
also  produces  various  sounds  of  importance. 

A  number  of  different  bronchial  sounds  may  be  distinguished;  these 
include  both  inspiratory  and  expiratory  sounds,  for  sometimes  an  ex- 
piratory sound  may  become  audible  and  clearly  appreciable,  or  may 
acquire  characters  of  the  greatest  importance. 

The  inspiratory  sound  may  be  strong,  rough,  rasping,  painful,  moist 
or  rattling.  The  pathological  expiratory  sounds  may  vary  between 
audible,  strong,  rough,  prolonged,  or  rattling.  The  varieties  of  souffle, 
or  rattle,  are  the  tubal  souffle  of  inspiration  or  expiration  (met  with 
in  pneumonia  or  broncho-j)neumonia) ;  the  soft,  deep-seated  pleuritic 
souffle  (peripneumonia) ;  the  continuous  cavernous  souffle  (met  with  in 
tuberculosis) ;  the  broad  amphoric  souffle,  in  which  the  vibrations  are 
extensive  and  of  metallic  character  (met  with  in  pneumo-thorax). 

As  to  the  varieties  of  rales  which  usually  accomj^any  these  souffles, 
they  may  all  be  met  with  in  tuberculous  animals,  and  comprise 
crepitant  and  sub-crepitant,  mucous,  cavernous,  snoring  and  sibilant 
rales. 


CHAPTER    II. 
NASAL    CAVITIES. 

SIMPLE    CORYZA. 

Simple  acute  coryza,  or  inflammation  of  tlie  mucous  membrane 
of  the  nasal  cavities,  is  of  comparatively  trifling  importance  in  bovine 
animals,  and,  were  it  not  for  the  possibility  of  gangrenous  coryza  being 
confused  with  it,  there  would  scarcely  be  any  necessity  for  a  special 
description. 

The  onset  of  coryza  is  indicated  by  repeated  sneezing  and  coughing, 
by  congestion  of  the  pituitary  mucous  membrane,  which  soon  begins  to 
secrete  abnormally,  and  by  difficulty  in  respiration,  which  becomes 
snoring  or  whistling. 

The  discharge,  transparent  at  first,  then  mucous  and  muco-purulent, 
is  abundant  in  quantity  ;  the  inflammation  is  arrested  at  this  point  or 
extends  towards  the  facial  sinuses,  the  pharynx  and  larynx ;  the  eyes  are 
swollen  and  watering,  and  almost  all  the  characteristic  symptoms  appear 
which  mark  the  onset  of  gangrenous  coryza.  Two  signs,  however,  are 
wanting.  The  appetite  is  fairly  well  maintained,  and  the  temperature 
little  above  normal.  Simple  coryza  occurs  at  all  times  of  the  year  in 
consequence  of  sudden  chills,  but  is  commonest  in  spring  and  autumn. 

At  first  the  distinction  between  this  condition  and  gangrenous  coryza 
can  only  be  ascertained  after  taking  the  temperature. 

The  prognosis  is  absolutely  favourable,  and  often  in  forty-eight 
hours  every  symptom  disappears. 

Treatment  is  confined  to  keeping  the  animals  in  stables  at  a  suit- 
able temperature,  sheltered  from  draughts.  Emollient  fumigations  and 
inhalations  of  turpentine,  creosote,  or  eucalyj^tus  oil  rapidly  check  the 
more  alarming  symptoms.  Warm  drinks  and  foods  and  cooked  roots 
are  recommended. 

In  sheep,  acute  coryza  as  a  consequence  of  chills,  etc.,  occurs  in 
autumn,  but  is  moi'e  commonly  due  to  a  parasitic  cause,  viz.,  invasion 
of  the  nasal  cavities  by  larvae  of  certain  oestridte.  During  the  succeeding 
winter  it  continues  under  the  form  of  chronic  coryza,  as  a  result  of  the 
larvte  retaining  their  position  in  the  sinuses. 


320  NASAL   CAVITIES. 

Treatment  of  this  ijarasitic  coryza  consists  in  trephining  the  sinuses 
and  destroying  the  kirvae. 

GANGRENOUS    CORYZA. 
Gangrenous  coryza  is  a  grave  disease  of  diphtheritic  character,  which 
at  first  seems  to  be  localised  in  the  mucous  membrane  of  the  upper 
respiratory  passages,   but  which   exhibits  a  tendency  to  afiect  all  the 
mucous  membranes  of  the  system. 

The  term  "gangrenous  coryza,"  adopted  in  France,  has  been  re- 
placed in  other  countries,  especially  in  Germany,  by  such  descriptions  as 
"  contagious  disease  of  the  head,"  and  "malignant  catarrhal  fever  of  the 
ox."  Old  writers  describe  gangrenous  coryza  as  a  disease  common  in  the 
Jura,  the  eastern  parts  of  France  generally,  and  in  the  valley  of  the 
Saone.  In  reality  this  disease  occurs  everywhere,  both  in  the  centre, 
west  and  north  of  France,  as  well  as  in  the  eastern  regions.  Serious 
outbreaks  frequently  occur  in  Germany  and  Italy. 

Symptoms.  Gangrenous  coryza  assumes  three  different  forms,  which, 
however,  only  represent  successive  degrees  of  intensity  of  the  attack. 
In  the  peracute  form  death  occurs  in  three  to  five  days,  even  when  the 
characteristic  signs  are  not  all  as  yet  apparent.  In  the  acute,  and  by 
far  the  most  frequent  form,  the  disease  lasts  from  fifteen  to  twenty  d'Ajs, 
and  also  ends  in  death  in  by  far  the  greater  number  of  cases.  Finally, 
in  the  form  usually  termed  chronic,  the  disease  lasts  from  four  to  eight 
weeks,  and  most  frequently  ends  in  recovery. 

Acute  and  jj^rac^ic  forms. — The  onset  is  marked  by  very  striking 
symptoms,  which  precede  the  local  symptoms  by  some  hours,  or  by  a 
day  or  more. 

The  temperature  rises  rapidly  from  the  normal  to  103°  or  105° 
Fahr.  (39'5°  to  41°  C),  or  even  higher.  Appetite  and  rumination  are 
entirely  suspended;  the  respiration  becomes  rapid  and  difficult,  while 
the  heart  beats  strongly  and  tumultuously ;  the  muzzle  is  dry,  the 
mouth  hot,  and  salivation  so  abundant  as  to  suggest  an  attack  of  foot- 
and-mouth  disease.  Fteces  and  urine  are  only  passed  at  long  intervals, 
and  dysuria  is  present. 

At  first  everything  seems  to  indicate  the  development  of  an  acute 
infectious  disease  ;  but  soon  afterwards  appear  local  indications  affect- 
ing the  respiratory,  ocular,  digestive,  urinary,  nervous  and  cutaneous 
systems. 

The  respiratory  symptoms  are  most  important,  and  almost  charac- 
teristic. Respiration  becomes  difficult,  rough  as  in  acute  coryza,  but 
soon  assumes  a  snoring  character,  and  is  accompanied  by  a  discharge, 
containing  false  membranes,  from  both  nostrils. 

The  serous  and  muco-purulent  discharge  becomes  rusty  or  reddish- 


GANGRENOUS   CORYZA.  321 

brown,  soon  acquires  a  very  foetid  smell,  and  is  found  to  contain  epithe- 
lial debris  and  yellowish-green  false  membranes.  After  the  least  effort 
to  cough  or  the  slightest  touch  on  the  membranes  themselves — some- 
times without  any  visible  cause  at  all — epistaxis  sets  in,  the  blood  being 
mixed  with  the  discharge  or  simply  escaping  in  the  form  of  reddish 
strings,  like  that  occasionally  seen  in  glanders. 

The  mucous  membrane  of  the  nasal  cavities  is  red,  turgid,  apt  to 
bleed,  and  painful  to  the  touch. 

Percussion  of  the  nasal  cavities,  sinuses,  and  even  of  the  horns  reveals 
everywhere  exceptional  sensibility. 

Sometimes,  but  only  in  certain  subjects,  the  lower  portions  of  the  head, 
including  the  muzzle,  nostrils,  lips  and  forehead,  become  infiltrated,  as 
though  the  case  were  one  of  purpura.  Thoracic  complications  are  rarely 
absent,  unless  the  disease  is  treated.  Towards  the  end  of  the  first  week 
the  respiration,  still  painful  and  snoring,  becomes  more  rapid  ;  and 
auscultation  reveals  at  various  points  in  the  lungs  areas  of  bronchitis 
and  of  l)roncho-pneumonia,  indicated  by  bronchial  rales,  rattling  breathing, 
and  tubal  souffles,  etc.  These  complications  are  accompanied  by  attacks 
of  coughing,  which  increase  the  discharge,  and  may  threaten  to  end  in 
suffocation.  This  hajDpens  when  large  masses  of  false  membranes  from 
the  bronchi  are  thrown  into  the  larynx  and  cannot  readily  be  ejected 
through  the  glottis,  which  has  been  reduced  in  size  by  oedematous 
infiltration  and  inflammation. 

Percussion  is  generally  useless.  The  appearance  of  the  eyes  is  also  very 
significant.  These  symptoms  develop  simultaneously  with  the  respiratory 
disturbance,  and  are  marked  by  infiltration  of  the  eyelids,  oedematous 
conjunctivitis,  and  ophthalmia.  The  cornea  becomes  whitish,  infiltrated, 
opaque,  and  sometimes  shows  ulcerative  keratitis  ;  or,  on  the  other  hand, 
it  remains  simply  semi-transparent,  and  through  it  the  media  of  the 
eye  may  be  seen  to  have  become  opalescent.  Ulcerative  keratitis  may 
develop  rapidly  and  end  in  perforation  of  the  cornea. 

In  certain  rare  instances  examination  with  the  ophthalmoscope  has 
revealed  the  existence  of  exudative  iritis  ;  this  condition  may  be  com- 
plicated with  synechia,  intra-ocular  haemorrhage,  and  result  in  perma- 
nent loss  of  vision. 

These  ocular  symptoms  are  accompanied  by  continuous,  abundant 
and  prolonged  discharge  of  tears,  intense  photophobia,  and  exceptional 
sensitiveness  to  manual  examination,  etc. 

Digestive  disturbance  appears  less  important,  and  may  be  regarded  as 
consequent  on  the  febrile  reaction,  the  general  disturbance,  or  the  condi- 
tion of  the  respiratory  apparatus.  But  complete  examination  will  show 
that  from  the  onset  of  the  disease  a  special  form  of  stomatitis  occurs. 
From  the  first  the  mouth  is  hot  and  dry :  soon    afterwards   abundant 

J).C.  Y 


322  NASAL   CAVITIES. 

reflex  salivation  occurs,  and  the  discharge,  Uke  that  from  the  nose,  becomes 
excessively  foetid.  This  stomatitis  differs  entirely  from  ordinary  forms 
of  stomatitis  and  from  the  stomatitis  peculiar  to  foot-and-mouth  disease, 
and  is  characterised  by  the  necrosis  of  fragments  of  epithelium  forming 
false  membranes.  These  on  being  shed  leave  exposed  numerous  ulcers 
distributed  over  the  tongue,  cheeks,  and  lips.  Neither  vesicles  nor  pus- 
tules are  produced,  but  merely  false  membranes  of  small  dimensions. 

The  false  membranes  and  ulcerations  occur  on  the  soft  palate  and  in 
the  pharynx. 

When  the  patients  survive  for  a  certain  time,  croupal  enteritis  and 
ulcerative  enteritis,  sometimes  accompanied  by  haemorrhage,  develop. 
The  administration  of  enemata  is  followed  by  the  passage  of  faeces  con- 
taining considerable  fragments  of  epithelium  or  of  streaks  of  blood. 
From  the  outset  these  digestive  complications  are  indicated  by  failure  to 
ruminate,  by  cessation  of  peristalsis  and  by  constipation,  which  is  usually 
succeeded  by  abundant  foetid  diarrhoea. 

Functional  disturbance  of  the  genito-urinary  api^aratus  is  rarer,  or 
at  least  more  difficult  to  detect.  The  animals  refuse  drink  ;  micturition 
seems  to  be  suspended  or  very  difficult.  The  urine  may  be  albuminous 
or  rose-coloured,  in  consequence  of  the  presence  of  haematin  ;  more  rarely 
it  is  purulent  or  sanguinolent.  There  may  also  be  urethritis,  cystitis, 
j)yelitis,  and  nephritis,  with  the  passage  of  hyalin  cylinders  in  the  urine, 
although  this  is  not  always  the  case. 

In  females  the  mucous  membrane  of  the  vagina  and  lips  of  the  vulva 
usually  seem  congested  and  oedematous  ;  but  it  is  rare  to  find  diph- 
theritic false  membranes,  as  on  the  buccal  and  nasal  mucous  membranes, 
etc.     On  the  other  hand,  vaginitis  and  exudative  metritis  are  common. 

Cutaneous  outbreaks  also  constitute  important  symptoms  by  which 
this  disease  is  recognised.  At  points  where  the  skin  is  fine,  on  the 
inner  surface  of  the  thighs,  around  the  girth,  on  the  inner  surface  of 
the  forearm,  and  on  the  mammae,  etc.,  an  exanthematous  eruption 
occurs,  followed  later  by  the  development  of  pustules,  which  at  first 
sight  might  suggest  cow-pox. 

These  pustules  are  prominently  apparent,  and  can  readily  be  detected 
on  palpation.  They  are  more  or  less  confluent,  hard,  and  without  a 
peripheral  oedematous  zone. 

In  the  case  of  the  mammae  these  pustules  occur  most  commonly  on 
the  teats,  are  round  or  slightly  oval  in  form,  bright  red  in  colour,  and 
sometimes  violet-red.  They  never  become  converted  into  vesico-pustules, 
as  in  cow-pox,  or  into  vesicles  ;  and  in  no  way  resemble  the  skin  eruption 
peculiar  to  foot-and-mouth  disease. 

Certain  nervous 'symptoms  have  also  been  described,  comprising 
trembling,  epileptiform  convulsions,  and  paraplegia  of  the  hind  quarters. 


GANGRENOUS   CORYZA.  323 

Moussu  has  never  seen  nervous  disturbance  assume  the  form  of 
epileptiform  convulsions,  and  it  is  possible  that  the  paraplegia  referred 
to  simply  marks  the  last  stage  of  the  disease. 

Causation.  The  essential  cause  of  gangrenous  coryza  has  not  yet 
been  definitely  ascertained.  Within  recent  years  teachers  of  the  highest 
authority  have  represented  the  disease  as  a  general  affection  belonging  to 
the  hpemorrhagic  forms  of  septicaemia  (Nocard  and  Leclainche).  Nocard 
has  found  ovoid  bacteria  in  the  false  membranes  of  the  larynx,  and 
Leclainche  a  paracoli-bacillus  in  the  mesenteric  ganglia  and  the  intes- 
tines, but  the  disease  has  never  been  reproduced  in  a  characteristic  and 
comjjlete  form  similar  to  the  clinical  type. 

Other  microbes  have  also  been  described  as  occurring  in  the  blood  or 
discharges  ;  but  attempts  to  transmit  the  disease  by  using  cultures  or  the 
different  morbid  products  which  observers  have  collected  have  invariably 
failed,  and  it  has  therefore  been  concluded  that  the  disease  is  not 
contagious,  but  merely  infectious. 

Moussu  does  not  regard  this  disease  as  a  haemorrhagic  septicaemia, 
because  the  blood  proves  sterile  unless  grave  pulmonary,  intestinal  or 
renal  complications  occur,  and  because  the  disease  appears  capable  of 
being  cured  in  a  short  time  by  simple  methods.  In  the  present  state  of 
knowledge  he  prefers  to  regard  it  as  an  infectious  disease  of  diphtheritic 
form,  at  first  localised  in  the  upper  respiratory  and  digestive  tracts, 
always  tending  towards  a  grave  toxaemia,  and  towards  complications  due 
to  various  other  infections. 

Even  though  direct  contagion  has  not  been  proved,  it  is  impossible 
to  doubt  that  stables  may  become  infected.  This  is  sufficiently  proved 
by  the  continued  appearance  of  the  disease  when  disinfection  is  neglected 
after  the  occurrence  of  the  first  case. 

It  is  possible  that  the  causes  formerly  assigned — viz.,  chills,  .the 
influence  of  draughts,  and  a  morbid  predisposition — may  increase  sus- 
ceptibility in  animals  otherwise  well  cared  for,  l)ut  it  is  quite  certain 
that  infection  of  the  stable  is  an  important  factor. 

Lesions.  The  lesions  vary  with  the  complications,  but  those  shown 
in  the  beginning  are  always  identical.  The  mucous  membrane  of  the 
nasal  cavities  is  congested,  inflamed,  sphacelated,  and  ulcerated  at  dif- 
ferent points.  The  turbinated  bones  and  the  ethmoid  cells  may  become 
necrotic ;  in  the  larynx  the  region  of  the  glottis  is  always  most  markedly 
affected ;  the  mucous  membrane  becomes  ulcerated  in  the  neighbourhood 
of  the  vocal  cords,  and  the  tissues  may  become  more  deeply  attacked. 

In  the  trachea  and  bronchi  the  mucous  membrane  undergoes  desqua- 
mation, and  may  become  ulcerated  at  the  points  where  false  membranes 
have  formed.  The  mucous  membrane  of  the  sinuses  is  always  affected, 
but  is  rarely  ulcerated. 

Y  2 


324  NASAL   CAVITIES. 

Such  complications  as  capillary  bronchitis,  broncho-pneumonia,  and 
gangrene  of  the  lung  may  be  noted. 

The  mucous  membrane  of  the  mouth  presents  a  violet-red  or 
blackish-red  colour ;  the  tongue  and  gums  are  swollen,  and  ulcers 
as  large  as  a  lentil  or  a  halfpenny'  may  occur  either  singly  or  in  a 
confluent  form. 

The  genito-urinary  apparatus  reveals  signs  of  croupal  cystitis, 
submucous  effusions  of  blood,  vaginitis  with  the  formation  of  false 
membranes,  acute  pyelitis,  etc. 

Diagnosis.  When  the  symptoms  are  fully  developed  the  diagnosis  of 
gangrenous  coryza  is  extremely  simple,  but  the  absence  of  some  of  these 
may  justify  hesitation  in  forming  an  opinion.  If  the  examination  is 
carefully  carried  out,  it  is  always  possible  to  distinguish  this  disease 
from  simple  coryza,  which  is  only  accompanied  by  trifling  fever,  and  in 
which  appetite  is  preserved ;  from  foot-and-mouth  disease,  with  its  very 
characteristic  buccal  eruption  and  absence  of  lesions  from  the  upper 
portions  of  the  respiratory  tract ;  and  from  contagious  ophthalmia. 

Prognosis.  Up  to  the  present  time  the  prognosis  has  always  been 
regarded  as  extremely  grave,  the  mortality  being  sometimes  as  high  as 
from  90  to  100  per  cent.,  and  moreover  the  cases  which  recover  are 
invariably  those  of  what  is  considered  the  chronic  form.  Sudden 
sinking  of  temperature  during  the  disease  is  an  unfavourable  sign. 
From  1894  to  1900  Moussu  never  cured  a  single  case,  whatever  his 
method  of  treatment ;  nevertheless,  it  now  seems  possible  to  regard  the 
condition  a  little  more  hopefully,  provided  that  no  incurable  compli- 
cation occurs  before  the  beginning  of  treatment. 

Treatment.  Of  all  the  modes  of  treatment  suggested — viz.,  anti- 
febrile agents,  general  stimulants,  purgatives,  diuretics,  external 
stimulant  applications,  etc. — none  have  succeeded.  Antiseptics  in- 
jected into  the  nasal  cavities,  antiseptics  given  internally,  milk  diet, 
and  all  the  methods  hitherto  suggested  are  equally  useless. 

The  only  treatment  which  appears  to  have  achieved  any  degree  of 
success  is  that  of  injecting  physiological  salt  solution  in  large  doses  (up 
to  six  quarts  per  da}^  divided  into  three  parts).  All  the  animals  treated 
by  this  method  recovered,  provided  they  presented  no  broncho-pulmonary 
complications. 

The  sole  inconvenience  of  this  treatment  is  the  difficulty  in  carrying 
it  out  when  the  animals  are  at  a  distance  from  the  practitioner.  It  is 
indispensable  that  they  should  be  close  at  hand,  in  order  that  he  himself 
may  make  the  injections  at  the  proper  time.  There  is  some  reason  for 
hoping,  however,  that  serum  from  animals  which  have  recovered  will 
prove  to  be  more  active  than  saline  injections. 

This  method  of  treatment  should  be  followed  up  by  the  most  rigid 


TUMOURS   OF   THK   NASAL   CAVITIES. 


325 


hygienic  precautions.  The  mouth,  nasal  cavities  and  eyes  should  fre- 
quently be  washed  with  antiseptic  solutions.  The  stables  should  be  freely 
ventilated,  and  the  floors  and  bed  kept  in  the  cleanest  possible  condi- 
tion, etc. 

Whenever  a  case  of  gangrenous  coryza  is  observed  it  should  be 
isolated,  and  the  stables  should  most  carefully  be  disinfected. 

TUMOURS    OF    THE    NASAL    CAVITIES. 

Apart  from  actinomycosis  of  the  upper  jaw,  tumours  of  the  nasal 
cavities  or  of  the  sinuses  are  not  frequent  in  bovine  animals.  They  are, 
however,  occasionally  met  with,  and  present  symptoms  which  must  be 


Fig.  167. — Transverse  section  through  the  nasal  cavities  near 
their  centre  (normal). 

carefully  studied  in  order  to  avoid  errors  of  diagnosis.  Usually  they 
are  of  the  nature  of  myxomata,  more  rarely  of  fibro-myxomata. 

Symptoms.  The  dominant  symptom  is  difficulty  in  breathing,  both 
when  moving  and  eating,  a  difficulty  which  is  sometimes  so  considerable 
as  to  cause  snoring  respiration  or  roaring.  Nevertheless,  examination  of 
the  trachea  and  of  the  lung,  visual  examination  of  the  lower  portions  of 
the  nasal  cavities,  and  manual  examination  of  the  pharynx,  larynx  and 
glottis  give  only  negative  results.  It  may  even  happen,  as  occurred  in 
the  case  from  which  the  illustration  herewith  was  taken,  that  percussion 
of  the  maxillary  sinus  reveals  normal  resonance. 

In  the  case  of  tumours  of  small  size  the  forehead  is  not  deformed. 
When,  on  the  other  hand,  the  tumour  partly  obstructs  the  nasal  cavities  it 


326 


NASAL   CAVITIES. 


may  thrust  on  one  side  the  septum  nasi  and  externally  cause  well-marked 
asymmetry  of  the  face.  Sero-mucous  or  muco-purulent  discharge  then 
occurs. 

The  diagnosis  is  somewhat  difficult,  for  continuous  or  temporary 
roaring  (or  at  any  rate  difficulty  of  respiration),  heing  the  dominant 
symptom,  must  he  distinguished  from  roaring  due  to  a  laryngeal  lesion 
like  paralysis  or  tumour  formation,  from  perilarj^ngeal  compression  due 
to  enlarged  retropharyngeal  glands,  and  from  tracheal  or  pulmonary 
lesions  ;  and  its  origin  must  he  located  in  the  nasal  cavities. 


Fig.  168. — Transverse  section  through  the  nasal  cavities  :  myxoma  of  the  right 
side  and  of  the  maxillary  sinus.     Deformity  of  the  forehead  and  face. 

The  prognosis  is  grave,  in  consequence  of  the  difficulty  of  exploring 
the  depth  of  these  cavities  and  of  the  possible  nature  of  the  tumour. 
Nevertheless,  in  the  case  of  simple  myxomata  permanent  recovery 
usually  follows  extirpation. 

Treatment  is  confined  to  extirpation,  which  is  quite  j^ossible  in  the 
case  of  pedunculated  tumours ;  in  the  case  of  sessile  tumours  free 
trepanation  of  the  roof  of  the  nasal  cavities  becomes  necessary.  The 
operation  is  quite  safe. 

PURULENT  COLLECTIONS  IN  THE   NASAL  SINUSES.     NASAL  GLEET. 

From  the  clinical  point  of  view  two  varieties  of  this  condition  may  be 

distinguished— inflammation  of  the  mucous  membrane  of  the  maxillary 


PURULENT   COLLECTIONS   IN   THE    FRONTAL   SINUS.  327 

sinus  and  inflammation  of  the  mucous  membrane  of  the  frontal  sinus 
and  of  the  horn  core.  These  forms  of  inflammation  frequently  lead  to 
suppuration.  The  pus  collects  in  the  depressions  and  divisions  of  the 
frontal  or  maxillarj^  sinus. 

PURULENT    COLLECTIONS    IN    THE    FRONTAL    SINUS. 

Causation.  In  the  majority  of  cases  inflammation  of  the  mucous 
membrane  of  the  frontal  sinus  is  produced  by  external  causes  :  fractures 
of  the  horns  and  horn  core  accompanied  by  haemorrhage  into  the  horn 
core  ;  fractures  of  the  horn  with  exposure  of  the  sinus  of  the  horn  core ; 
wounds  and  violent  blows  on  the  occipital  region  or  the  frontal  bone  ; 
cracks  or  depressions  of  the  external  wall  of  the  sinus,  etc. 

In  all  these  cases,  whether  blood  is  eft'used  or  the  mucous  membrane 
of  the  sinus  is  merely  infiltrated  with  serum,  infection  may  be  produced 
by  germs  being  deposited  from  the  air  passing  through  the  nasal  cavities 
and  causing  sui^puration. 

Purulent  collections  in  the  frontal  sinus  may  result  from  continued 
irritation,  like  that  due  to  a  badly  fitting  yoke.  They  also  occur  as  an 
accidental  comj)lication  of  general  diseases  like  gangrenous  coryza. 

Symptoms.  The  catarrh  or  purulent  collection  in  the  sinus  may  be 
unilateral  or  bilateral,  and  the  symptoms  vary,  according  to  the  form 
which  it  assumes. 

Unilateral  collections. — Nasal  haemorrhage  is  often  the  first  symptom, 
but  this  is  often  regarded  as  of  little  importance,  because  the  formation  of 
pus  does  not  occur  until  very  much  later.  The  animal  shows  ill-defined 
pain,  loses  appetite,  remains  dull  and  somnolent,  and  carries  its  head  on 
one  side.  The  horn  on  the  injured  side  is  hot  and  sensitive,  and  at  a 
later  stage  the  eye  becomes  affected  by  contiguity  of  tissue.  It  is  then 
swollen,  closed,  and  watery ;  the  conjunctiva  is  infiltrated,  and  somewhat 
inflamed.  Sensibility  and  partial  or  comj)lete  dulness  of  the  affected 
side  may  be  detected  by  palpation  and  percussion.  On  the  animal 
being  made  to  cough,  a  yellowish  or  greyish-white  discharge  of  very 
fcetid  and  sometimes  putrid  character  escapes. 

Bilateral  collections. — Catarrh  is  rarely  bilateral  at  first ;  but  if  the 
unilateral  lesion  is  not  treated,  it  affects  the  median  septum  dividing  the 
two  cavities,  and  the  inflammation  extends  to  the  second  sinus.  The 
animal  then  shows  dull  pain,  and  exhibits  marked  depression ;  sometimes 
it  appears  quite  prostrate.  The  head  is  carried  low  and  inclined  towards 
the  ground,  while  the  above-mentioned  ocular  symptoms  and  the  indi- 
cations furnished  by  palpation  and  percussion  extend  to  both  sides. 
Coughing  produces  momentarily  a  double  discharge,  which  the  animal 
disposes  of  after  the  fashion  of  horned  cattle. 


328  NASAL    CAVITIES. 

Diagnosis.  The  diagnosis  only  presents  difficult}^  in  the  early  stages. 
Later  the  warmth  and  sensitiveness  of  the  horns,  the  partial  dulness, 
offensive  character  of  the  discharge,  etc.,  render  diagnosis  easy. 

The  disease  is  not  likely  to  be  mistaken  for  gangrenous  coryza, 
despite  the  condition  of  the  eyes,  because  it  develops  slowly,  progres- 
sively, and  without  marked  fever. 

Prognosis.  If  treated  early,  unilateral  or  bilateral  collections  of  pus 
in  the  sinuses  are  capable  of  cure,  but  later  when  bodily  health  is  im- 
paired and  the  local  lesions  of  the  mucous  membrane  very  pronounced, 
there  is  less  chance  of  success. 

Lesions.  The  initial  lesions  consist  in  cracks,  fissures,  or  fractures 
of  the  bones  of  the  face  or  exostoses  of  traumatic  origin.  In  other  cases 
the  mucous  membrane  alone  is  aflected.  Asa  result  of  chronic  irrita- 
tion it  becomes  thickened,  inflamed,  and  ulcerated,  and  granulates 
freely.  The  depressions  in  the  sinuses  contain  grumous,  fcetid  pus, 
which  irritates  the  surrounding  tissues  and  produces  pain  and  general 
symptoms  of  cerebral  irritation,  which  are  sometimes  very  disquieting. 

Treatment.  Numerous  methods  of  treatment  were  formerly  recom- 
mended, such  as  absolute  rest,  bleeding,  cold  aft'usions,  perforation  of  a 
horn,  section  of  a  horn,  etc.     None  of  these  is  of  any  value. 

At  first,  provided  only  a  certain  degree  of  sensitiveness  and  simple 
catarrh  without  suppuration  exist,  antiseptic  fumigations  with  tar,  car- 
bolic acid,  thymol,  etc.,  are  useful ;  but  later,  when  pus  has  formed, 
they  are  useless.  At  this  period  the  only  rational  and  efficacious  treat- 
ment consists  in  trepanation.  In  unilateral  collections  three  openings 
are  necessary. 

The  first  is  an  opening  into  the  sinus  of  the  horn  core.  It  is  made 
f  to  f  of  an  inch  above  the  horn-secreting  band  of  the  horn.  It  must 
not  be  forgotten,  however,  in  planning  such  an  opening  that  the  sinus  of 
the  horn  core  only  exists  in  a  rudimentary  condition  in  young  animals, 
and  that  it  is  scarcely  possible  to  trephine  the  horns  before  the  patient 
is  three  years  of  age. 

The  second  opening  is  made  towards  the  upper  part  of  the  frontal 
sinus  about  f  inch  below  the  horn-secreting  ring  at  the  base  of  the 
horn  and  in  a  line  with  the  axis  of  the  horn  core  itself.  Whatever  the 
animal's  age  and  however  little  the  sinuses  may  be  developed,  this 
opening  is  certain  to  expose  the  cavity  of  the  frontal  sinus. 

In  old  animals  where  the  frontal  sinus  is  enormously  developed,  and 
where  very  large  depressions  exist  in  the  orbital  region,  a  third  opening 
should  be  made  just  above  a  transverse  line  uniting  the  upper  margins 
of  the  two  orbits  and  inside  the  suborbital  suture. 

These  openings  having  been  made,  treatment  consists — firstly,  in 
completely  washing  out  the  cavity  with  boiled  water,  cooled  to  95°  or 


PURULENT   COLLECTIONS    IN    THE    MAXILLARY    SINUS.  329 

100°  Fahr. ;  and,  secondly,  in  injecting  antiseptic  and  astringent  solutions 
so  as  to  check  the  formation  of  pus.  Among  such  may  be  mentioned 
3  per  cent,  carbolic  solution,  5  per  cent,  carbolic  glycerine,  2  per  cent, 
solution  of  iodine  in  iodide  of  potassium,  etc. 

Whatever  the  drugs  employed,  the  cavities  should  be  washed  out 
every  day,  first  with  plain  sterilised  water,  and  then  with  antiseptic 
solutions  at  the  body  temperature,  since  cold  solutions  often  cause 
inflammation  of  the  mucous  membrane  of  the  opposite  sinus. 

PURULENT    COLLECTIONS    IN    THE    MAXILLARY    SINUS. 

This  disease  is  much  rarer  than  that  of  the  frontal  sinus,  and  only 
within  the  last  few  years  (Eies,  1899)  has  a  really  good  description  been 
given  of  it. 

The  causation  is  imperfectly  understood.  Injuries  to  the  suborbital 
region  and  maxillary  ridge,  caries  of  the  molar  teeth,  and  inflammation 
occurring  during  the  development  of  general  diseases  represent  the 
princii^al  causes. 

The  dominating  and  characteristic  symptom  of  the  presence  of  pus 
in  the  maxillary  sinus  consists  in  incessant  snorting,  accompanied  by 
violent  movements  of  the  head  and  the  discharge  of  purulent  or  muco- 
purulent material. 

At  the  beginning  of  these  attacks  of  snorting,  which  are  produced 
by  the  reflux  of  pus  from  the  sinus  towards  the  nasal  cavities,  the 
respiration  becomes  snoring  and  rapid,  and  the  animal  makes  sniffing 
movements  as  though  the  nasal  cavities  were  partially  obstructed.  After 
these  crises,  the  respiration  again  becomes  silent. 

Contrary  to  what  has  been  observed  in  purulent  collections  in  the 
frontal  sinus,  the  discharge  is  unilateral,  reddish  yellow  in  colour, 
viscous  in  consistence,  and  is  accompanied  by  clots  of  a  gelatinous 
material  or  even  of  blood. 

During  the  attacks  of  snorting,  the  discharge  resembles  that  of 
croupal  or  pseudo-membranons  bronchitis,  but  the  material  discharged 
is  not  moulded  on  the  internal  shape  of  the  bronchi.  The  masses  of 
discharge  are  irregular  in  form,  and  appear  as  though  made  up  of  fibrous 
tissue  matted  together.  Attention  having  been  attracted  by  the  dis- 
charge, exploration  of  the  trachea  and  chest  reveals  nothing  ;  on  an 
examination  of  the  sinuses,  however,  palpation  and  percussion  betray 
a  certain  amount  of  sensitiveness,  together  with  partial  or  comj^lete 
dulness,  and  the  lesion  is  discovered. 

Diagnosis.  Confusion  between  pus  formation  in  the  maxillary  and 
frontal  sinuses  can  be  avoided  by  careful  examination. 

Prognosis.     The  prognosis  is  not  very  grave  ;  the  animals  maintain 


330  NASAL   CAVITIES. 

their  appetite,  but  become  thinner,  and  the  condition  shows  no  tendency 
to  spontaneous  cure. 

Treatment.  The  only  rational  treatment  consists  in  trephining,  an 
operation  practised  immediately  aljove  the  maxillary  tuberosity  and  over 
the  lowest  part  of  the  sinus  (Fig.  164).  This  opening  allows  the  cavity 
to  be  washed  out  and  the  sinus  drained. 

Antiseptic  treatment  exactly  resembles  that  of  purulent  collections 
in  the  frontal  sinus.  Injections  of  astringents,  dilute  carbolic  acid  and 
iodine  solutions,  etc.,  are  recommended. 

CESTRUS    LARViE    IN    THE    FACIAL    SINUSES    OF    SHEEP. 
(false  sturdy.) 

Causation.  This  disease  of  sheep,  which  sometimes  produces  vertigo 
reseml)ling  that  shown  in  gid  or  sturdy,  is  produced  by  the  growth  of 
larvte  of  (Eslnis  oris  in  the  frontal  sinuses.  The  oestrus  of  the  sheep 
assumes  perfect  insect  form  during  the  fine  days  of  summer  from  July  to 
September.  The  females  swarm  around  the  flocks  and  attempt  to  alight 
on  the  animal's  head  close  to  the  nostrils,  where  they  deposit  their  eggs 
or  larvae.  The  larvfe  crawl  into  the  nostrils,  thence  into  the  nasal  cavities, 
the  meatus,  and  finally  the  sinuses,  where  they  become  fixed.  In  these 
sinuses  they  undergo  complete  development,  increasing  from  a  length  of 
about  Jo  inch  to  from  f  to  1  inch  before  their  transformation  into  the 
nymph  and  perfect  insect.  They  remain  in  the  sinus  for  eight  to  ten 
months.  When  numerous  and  well  developed  they  may  fill  the  whole 
of  the  cavity. 

Symptoms.  It  is  easy  for  a  careful  observer  to  note  the  time  at 
which  the  larvae  penetrate  the  sinus.  D.uring  the  hottest  hours  of  the 
day  the  adult  insects  are  continually  hovering  over  the  flocks,  and  on 
watching  carefully  one  sees  sheep  suddenly  become  excited,  tap  with  their 
feet,  rul)  their  faces  against  any  hard,  resisting  object  in  the  neighbour- 
hood, plunge  their  nostrils  into  the  dust,  and  snort  violently. 

When  the  larvae  have  penetrated  the  nasal  cavities  they  produce 
frequent  attacks  of  sneezing  by  irritating  the  mucous  membrane,  and 
cause  an  intense  sero-mucous  and  afterwards  a  moderate  muco-purulent 
coryza.  As  long  as  the  larvae  remain  of  small  size,  the  apparent  results 
they  produce  are  insignificant,  as  during  the  first  months  of  winter ;  but 
when  they  are  numerous,  and  have  become  of  considerable  size,  they 
cause  symptoms  which  might  suggest  an  attack  of  gid  or  sturdy. 

Thus  the  bodily  movements  become  spasmodic,  the  gait  irregular, 
and  the  animals  show  attacks  of  vertigo.  They  stagger  and  fall,  making 
convulsing  movements,  grinding  their  teeth  and  rolling  their  eyes,  while 
frothy  saliva  escapes  from  the  mouth,  etc. 


CESTRUS   LARV.*:   IN   THE    FACIAL   SINUSES   OF   SHEEP. 


331 


Death  may  occur  during  such  attacks,  which,  however,  are  happily 
very  rare.  Most  commonly  the  animals  are  simply  dull  and  somnolent. 
They  feed  badly,  carry  their  heads  low,  and  sometimes  hide  themselves 
under  the  mangers  or  in  corners. 

In  exceptional  circumstances  they  bury  their  heads  in  the  wool  or 
carry  them  high  in  the  air  in  walking,  while  they  lift  their  front  legs 
high,  with  a  stepping  movement. 

Diagnosis.     The  diagnosis  of  parasitic  invasion  of  the  sinus  in  the 


Fig.  169. — Parasitic  invasion  of  the  sinuses  and  coenurosis  (showing  the 
seat  of  operation  in  either  condition). 


sheep  is  rather  difficult,  because  certain  of  the  symptoms  suggest  gid. 
One  never  finds  the  signs  of  true  gid,  however,  and,  on  the  other  hand,  a 
certain  amount  of  discharge  and  attacks  of  snorting  always  exist.  Finally, 
gid  (coenurosis)  only  attacks  young  animals,  whilst  the  larvae  of  oestridae 
are  commonest  in  adults. 

To  confound  the  disease  with  verminous  bronchitis  is  still  less  likely, 
for  although  a  discharge  exists  in  both  cases,  this  is  accompanied  by 
cough  in  bronchitis,  and  only  by  sneezing  attacks  in  infection  of  the 
sinuses. 


332  NASAL   CAVITIES. 

Finally,  in  bronchitis,  histological  examination  leads  to  the  discovery  of 
eggs  or  embryos  of  the  strongjdes.  The  diagnosis  becomes  very  easy  on 
post-mortem  examination,  the  identification  of  the  larva;  of  cestridte  l)eing 
extremely  simple. 

Prognosis.  The  prognosis  is  only  grave  when  infestation  is  very 
pronounced.  Most  commonly  the  parasites  complete  their  development 
without  producing  disquieting  symptoms ;  as  summer  approaches  they 
are  expelled  and  recovery  occurs. 

Lesions.  The  only  lesions  consist  in  very  active  inflammation  of  the 
mucous  membrane  of  the  sinus,  which  appears  excessively  hypertrophied, 
and  in  the  existence  of  larv».  These  develop  in  the  midst  of  a  magma  of 
purulent,  foetid  discharge.  The  number  of  parasites  usually  ranges  from 
two  to  twenty,  although  Zlirn  declares  that  he  has  found  as  many  as 
eighty  in  one  subject. 

Treatment.  Many  precautions  have  been  suggested  for  preventing 
infestation.  Many  are  impossible  or  difficult  to  carry  out  in  current 
practice,  even  the  soaking  of  the  nostrils  in  empyreumatic  oil,  and  the 
majority  are  useless.  The  only  suggestion  to  which  we  attribute  any 
importance  consists  in  trying  to  prevent  the  perfect  insects  from  obtain- 
ing a  lodgment  in  cavities  in  the  walls  or  roofs  of  sheep-sheds. 

The  really  efficacious  modes  of  treatment  are  also  few  in  number,  for 
the  larvae  are  so  firmly  lodged  in  the  mucous  membrane  of  the  sinuses  that 
they  can  only  be  detached  after  these  have  been  trephined.  The  use  of 
nasal  injections,  embrocations  and  powders,  with  the  object  of  making 
the  animal  sneeze,  are  ineffectual. 

Trepanation  should  not  be  performed  until  it  is  quite  clear  that  the 
flock  is  badly  infested,  and  when  serious  symptoms  appear  to  threaten 
the  lives  of  some  of  the  animals. 

The  operation,  although  very  simple,  requires  care  on  account  of  the 
thinness  of  the  bones. 

The  anatomical  directions  are  the  middle  line  of  the  head,  and  a 
transverse  line  uniting  the  upper  margin  of  the  two  orbits.  The  orifices 
are  made  in  the  two  lower  angles  produced  by  the  intersection  of  these 
lines  (Fig.  169). 

It  is  then  easy  to  remove  with  the  fingers  or  forceps  the  larvae  situated 
immediately  below  the  point  of  trepanation,  and  afterwards  to  wash  out 
thoroughly  the  cavities  of  the  sinuses.  If  some  lie  at  points  which  cannot 
be  directly  reached,  they  can  be  killed  by  injecting  a  little  benzine  and 
water.     This  proceeding  is  quite  safe. 


CHAPTER     III. 
LARYNX,   TRACHEA    AND    BRONCHI. 

LARYNGITIS. 

Laryngeal  diseases  are  common,  but  are  usually  only  the  local  expres- 
sion of  some  grave  general  infection,  such  as  foot-and-mouth  disease, 
gangrenous  coryza,  or  tuberculosis.  Pathological  conditions  such  as  these 
can  be  disregarded  for  the  moment,  as  they  will  receive  attention  under 
special  heads. 

The  two  current  forms  of  laryngeal  disease  are  acute  laryngitis  and 
stridulous  laryngitis. 

ACUTE    LARYNGITIS. 

Acute  laryngitis,  like  simple  coryza,  of  which  it  is  often  only  an 
accompaniment,  is  caused  by  chill,  by  irritant  vapours,  by  smoke,  etc., 
or  by  external  traumatic  causes. 

The  cough  is  dry  and  painful  at  first ;  afterwards  it  is  accompanied 
by  a  discharge  or  by  the  swallowing  of  mucus  or  muco-purulent  products. 
The  respiration  sometimes  appears  accelerated  and  difficult,  but  roaring 
or  whistling  and  marked  fever  are  rare.  The  slightest  pressure  over  the 
laryngeal  region  causes  pain  and  attacks  of  coughing.  The  respiration 
is  normal  while  the  animal  is  at  rest,  provided  that  the  laryngitis  remains 
localised ;  frequently,  how^ever,  it  is  complicated  with  bronchitis. 

The  appetite  is  somewhat  diminished,  but  all  these  symptoms  very 
rapidly  improve. 

The  diagnosis  is  leased  on  the  frequency  of  the  cough  and  the  sensi- 
tiveness of  the  throat  region. 

The  prognosis  is  favourable  in  cases  of  simple  laryngitis. 

Treatment  consists  in  the  administration  of  steam  inhalations, 
warm  drinks,  the  application  of  mustard  plasters  or  blisters  around 
the  laryngeal  region,  and  the  administration  of  expectorants  to  facili- 
tate  mucous  discharge. 

PSEUDO-MEMBRANOUS    LARYNGITIS. 

Pseudo-membranous  laryngitis,  also  termed  by  German  authors 
croupal  or  diphtheritic  laryngitis,  because  it  bears  a  certain  resemblance 


334  LARYNX,  TRACHEA  AND  BRONCHI. 

to  human  croup,  is  characterised  l)y  the  formation  of  false  membranes 
on  the  vocal  cords,  arytenoid  cartilages,  and  subglottal  region,  etc. 

In  France  it  has  been  described  under  the  name  of  stridulous 
laryngitis,  because  its  dominant  symptom  consists  in  attacks  of  intense 
dyspnoea,  during  which  the  respiration  is  accompanied  by  whistling. 
Without  making  any  attempt  to  prejudge  the  nature  of  the  disease,  which 
resembles  the  pseudo- diphtheritic  forms  of  larj'ngitis  in  man,  we  prefer 
the  term  pseudo-membranous  laryngitis.  Moreover,  this  pseudo-mem- 
branous laryngitis  very  frequently  accompanies  pseudo-membranous  sore 
throat,  tracheitis  and  bronchitis,  with  formation  of  false  membranes. 

Causation.  The  causes  suggested  are  similar  to  those  of  simple  sore 
throat :  they  include  chills,  the  ingestion  of  ice-cold  water,  or  the  inhala- 
tion of  irritant  gases,  during  outbreaks  of  fire,  etc.,  etc.  ;  but  it  is  quite 
certain  that  here,  as  in  many  similar  cases,  a  primarily  simple  laryngitis 
is  complicated  by  a  well-marked  infection. 

Symptoms.  The  general  symptoms  seen  during  the  early  stages 
consist  in  loss  of  appetite,  general  depression,  rigors,  and  a  rise  in 
temperature  of  1°  to  2°  Fahr. 

Then,  after  twenty-four  or  forty-eight  hours,  the  respiration  becomes 
more  rapid,  difficult,  whistling  and  dyspnoeic,  with  intermittent  attacks 
of  suffocation. 

Examination  of  the  chest  gives  negative  results,  but,  on  the  throat 
being  manipulated,  the  slightest  pressure  exercised  over  the  larynx  pro- 
duces attacks  of  coughing.  During  the  first  few  days  these  attacks  are 
loud,  spasmodic,  and  difficult,  but  on  succeeding  days  they  lead  to  the 
discharge,  from  the  nostrils  or  mouth,  of  masses  of  false  membrane 
accompanied  by  whitish  and  sometimes  blood-stained  fluid.  Secondarily 
the  mucous  membrane  of  the  nasal  fossre  appears  inflamed  to  a  varying 
degree.  The  conjunctiva  is  also  affected,  the  eyes  are  watering.  An 
important  symptom  consists  in  the  fact  that  this  watering  is  accom- 
panied by  internal  ophthalmia,  as  in  gangrenous  coryza. 

In  consequence  of  the  respiratory  difficulty,  the  animal  takes  up  a 
characteristic  attitude,  holding  its  neck  stiffly  in  a  horizontal  position 
and  its  head  completely  extended ;  the  nostrils  are  widely  dilated. 
When  the  disease  is  fully  developed  rumination  is  suppressed,  the 
bowels  are  constipated  and  the  faeces  are  coated  as  in  grave  cases  of 
enteritis,  the  yield  of  milk  diminishes,  the  heart  beats  feebly,  the  pulse 
remains  small ;  death  may  occur  from  asphyxia,  and  proljably  also  from 
intoxication. 

The  disease  usually  lasts  from  eight  to  ten  days,  but  death  may  occur 
earlier.  In  the  majority  of  cases,  however,  the  animal  can  be  saved. 
All  the  symptoms  diminish,  the  temperature  falls,  rumination  again 
ajipears  and  with  it  appetite,  and  the  whole  condition  becomes  normal. 


TUMOURS   OF   THE   LARYNX.  335 

Many  animals,  however,  remain  thin  and  recover  slowly ;  these 
are  principally  cases  which  have  suffered  from  pseudo-membranous 
bronchitis. 

Lesions.  The  lesions  may  be  confined  to  the  larynx,  but  may  also 
invade  neighbouring  cavities.  They  consist  in  the  formation  of  muco- 
albuminous  and  fibrinous  exudates,  covering  the  mucous  membrane  in 
superposed  layers,  penetrating  the  epithelial  stratum,  and  adhering  so 
strongly  to  the  corium  that  attempts  to  loosen  them  cause  the  deeper 
seated  structures  to  bleed. 

Diagnosis.  The  symptoms  are  sufficiently  well  marked  to  prevent 
any  confusion  arising  except  with  gangrenous  coryza,  but  in  this  case 
there  is  no  ophthalmia  lesion  of  the  nasal  cavities,  cutaneous  eruption, 
or  eruption  over  the  claws. 

The  prognosis  is  grave  when  the  disease  attacks  debilitated  or 
exhausted  animals. 

The  treatment  is  confined  entirely  to  treating  symptoms.  As  in  all 
acute  inflammatory  affections,  moderate  bleeding,  sinapisms  over  the 
region  of  the  larynx,  repeated  as  often  as  necessary,  or  applications  of 
antimonial  ointment  have  been  recommended.  Applications  of  moxas 
or  setons  in  the  neighbourhood  of  the  dewlap  might  possibly  prove  of 
value. 

Internally  tartar  emetic,  in  doses  proportioned  to  the  size  of  the 
animal  (2i  to  3  drachms  in  adults),  has  been  recommended;  also  iodide 
of  potassium. 

General  stimulants,  like  alcohol,  coffee,  tea,  acetate  of  ammonia,  and 
suitable  hygienic  conditions  suggest  themselves.  Tepid  drinks  can  be 
given  freely.  Nourishing  and  easily  digested  food,  and  a  ration  of  milk 
complete  the  treatment. 

Emollient  and  antiseptic  fumigations  are  also  of  value,  as  in  ordinary 
sore  throat  or  laryngitis,  for  they  favour  the  separation  and  discharge 
of  the  false  membranes. 

TUMOURS    OF    THE    LARYNX. 

Acute  forms  of  pseudo-membranous  laryngitis,  or  even  tuberculous 
laryngitis,  are  not  the  only  diseases  which  affect  the  larynx.  It  is  by  no 
means  exceptional  to  discover  intra-laryngeal  tumours,  mucous  polypi, 
tuberculomes,  and  growths  due  to  actinomyces,  etc. 

The  presence  of  these  tumours  is  indicated  by  difficulty  in  respira- 
tion, fits  of  coughing,  and  threatened  suffocation,  accompanied  by  dis- 
charges of  varying  character. 

When  the  tumour  is  largely  sessile,  the  respiration  may  simply  be 

snoring  or  whistling,  without  any  suggestion  of  suffocation  ;  but  if,  on 

•  the  other  hand,  it  is  pedunculated,  displacement  of  the  polypus  produced 


330 


LARYNX,  TRACHEA  AND  BRONCHI. 


by  the  currents  of  air  during  inspiration  and  expiration  causes  spasm  of 
the  glottis,  fits  of  coughing  and  threatened  suffocation. 

The  diagnosis  is  not  always  easy,  though  examination  of  the  nasal 
cavities,  the  sinuses,  trachea  and  chest  gives  negative  results.  Ausculta- 
tion of  the  larynx  may  suggest  the  existence  of  the  lesion,  but  an  exact 
diagnosis  can  only  be  attained  by  digital  examination  of  the  larynx 
through  the  pharynx. 

The   prognosis    of    these    tumours    is   grave,   because   death    from 

asphyxia  may  occur  during  an 
attack  of  coughing  or  as  a  con- 
sequence of  the  fits  of  suffoca- 
tion. 

Treatment.  As  it  is  usually 
extremely  difficult,  if  not  impos- 
sible, to  discover  the  exact  nature 
of  the  tumour,  medical  treat- 
ment, except  for  instance  in  the 
case  of  actinomycosis,  is  of  very 
uncertain  value. 

Surgical  treatment  alone  sug- 
gests itself.  Before  attempting 
an  operation  tracheotomy  should 
be  performed  and  a  metal  canula 
inserted.  The  animal  having 
been  cast,  and  the  upper  laryn- 
geal vegion  anaesthetised  by 
means  of  cocaine,  a  vertical  in- 
cision is  made  in  the  median 
line  below  the  larynx,  passing 
through  the  skin,  the  vertical 
junction  between  the  neck  mus- 
cles and  the  three  first  circles 
of  the  trachea,  and  access  is 
thus  obtained  to  the  larynx  and  subglottal  region.  The  operation 
should  only  be  performed  in  exceptional  cases,  such  as  that  of  a  valu- 
able stud  animal. 

Provided  that  the  new  growth  has  a  well-developed  pedicle  it  can  be 
removed  through  the  mouth  by  the  use  of  an  ecraseur  or  simply  by 
tearing  out. 

BRONCHITIS. 

Diseases  of  the  bronchi  in  bovine  animals  reveal  very  different 
characters,  according  to   the   nature  of   the  primary  cause,  for  which 


Fig.  170. 


Sessile  form  of  intra-laryngeal 
polypus. 


SIMPLE    ACUTE    BRONCHITIS.  337 

reason  cases  occur  of  simple  acute  bronchitis,  verminous  bronchitis, 
simple  chronic  bronchitis,  pseudo-membranous  bronchitis,  tuberculous 
bronchitis,  etc. 

SIMPLE    ACUTE    BRONCHITIS. 

Simple  acute  bronchitis  coexists  with,  or  is  often  only  the  logical 
and  inevitable  complication  of,  coryza  and  acute  laryngitis.  It  is  com- 
monly associated  with  inflammation  of  the  mucous  membrane  of  the 
trachea. 

It  accompanies  cold  and  wet  seasons,  and  usually  appears  with  the 
autumn  frosts,  in  animals  still  at  grass.  In  animals  under  shelter  it 
occurs  after  undue  exertion  followed  by  chills,  and  after  sudden  rain 
storms.  It  also  attacks  working  oxen,  which  are  much  exposed  to  the 
weather. 

The  symptoms  follow  very  rapidly  on  the  determining  cause.  They 
are  ushered  in  by  rigors,  trembling  attacks,  diminution  or  loss  of  appe- 
tite, arrest  of  rumination,  acceleration  of  breathing,  and  the  appearance 
of  a  rough  and  spasmodic  cough. 

In  ordinary  cases  these  symptoms  rapidly  diminish,  even  without 
treatment.  The  appetite  again  becomes  moderate,  rumination  returns, 
but  the  cough  remains  more  or  less  rough  and  spasmodic,  ending  in  the 
discharge,  or  more  often  in  the  swallowing,  of  abundant  bronchial 
mucus. 

This  is  the  condition  at  the  period  of  crisis.  Percussion  of  the 
thorax  reveals  normal  resonance.  On  auscultation  of  the  sides  during 
the  period  of  onset,  rough  rales  are  heard,  which  at  the  period  of  crisis 
are  replaced  by  mucous  rales.  The  cough  diminishes  in  frequency,  and 
after  a  fortnight  everything  again  becomes  normal. 

The  diagnosis  is  very  easy,  the  important  point  being  not  to  con- 
fuse common  bronchitis  with  tuberculous  bronchitis,  which  very  often 
assumes  a  chronic  form. 

Prognosis.  The  prognosis  is  not  grave,  even  though  the  disease  may 
assume  a  chronic  condition. 

Treatment  does  not  differ  from  that  of  acute  bronchitis  in  the  horse. 
It  consists  in  antiseptic  and  steam  fumigations,  tepid  drinks,  the 
administration  of  doses  of  2  to  3  drachms  Kerme's  mineral  in 
adult  animals,  and  of  1  to  IJ  drachms  of  iodide  of  potassium,  given 
in  a  mash  or  in  honey  electuary.  During  convalescence  tar  water 
should  be  administered. 

CHRONIC    BRONCHITIS. 

Chronic  inflammation  of  the  mucous  membrane  of  the  large 
bronchi  and  trachea  may  follow  acute  bronchitis,  but  it  is  also  a  frequent 

D.C.  Z 


838  LARYNX,  TRACHEA  AND  BRONCHI. 

termination  of  verminous  bronchitis.  It  is  fomid  in  fully  developed 
animals,  adult  or  old,  and  particularly  in  those  inhabiting  wet,  cold 
vallej's. 

It  is  characterised  by  frequent  paroxysms  of  coughing,  which  appear 
on  the  slightest  provocation,  such  as  the  action  of  cold  air  on  leaving  the 
stable  or  of  the  air  of  a  confined  space  on  animals  returning  from  the 
open ;  concussion  of  the  chest  by  the  pleximeter,  squeezing  of  the  loins, 
rapid 'movement,  etc. 

This  coughing  is  accompanied  by  the  discharge  of  mucus,  which 
rarely  arrives  at  the  nostrils,  but  is  swallowed  in  passing  through  the 
pharynx.  Such  mucus  is  always  thick,  greenish  yellow  in  colour,  and 
w^ithout  smell. 

The  respiration,  although  regular  whilst  the  animal  is  at  rest,  becomes 
accelerated  on  moving,  and  after  attacks  o£  coughing.  It  is  sometimes 
rapid  and  whistling. 

Percussion  discloses  neither  partial  nor  complete  dulness,  but  every- 
where irregularly  distributed  mucous  rattling  and  sibilant  rales  are 
revealed  by  auscultation. 

There  is  no  fever,  the  appetite  is  maintained,  and,  what  is  an  even 
more  important  point,  animals  in  good  condition  preserve  their  flesh. 
Interlobular  pulmonary  emphysema  and  emphysema  resulting  from 
dilatation  are  inseparable  accompaniments  of  chronic  bronchitis,  for 
which  reason  the  flank  respiratory  movement  is  frequently  very 
^uarked. 

The  diagnosis  is  of  only  moderate  difficulty,  because  although  in 
certain  conditions  the  disease  may  be  mistaken  for  tuberculosis  or 
emphysema,  it  can  be  distinguished  by  bacteriological  examination  of 
the  discharge,  by  an  injection  of  tuberculin,  by  careful  auscultation, 
and  by  consideration  of  the  general  condition. 

Lesions.  The  walls  of  the  bronchi  are  thickened,  the  submucous 
connective  tissue  is  sclerosed,  the  muscular  fibres  are  modified  in 
structure,  and  have  become  fibrous,  while  the  epithelial  layer  is  des- 
quamated and  suppurating.  The  peribronchial  tissue  also  undergoes 
sclerosis,  and  in  certain  cases  the  smaller  bronchi  present  marked 
dilatations  resembling  small  caverns  (bronchi-ecstasis). 

Treatment  can  never  be  more  than  palliative  ;  the  aim  should  be  to 
prevent  the  lesions  becoming  aggravated,  and  to  check  the  pathological 
secretion  from  the  bronchi,  but  the  lesions  already  existent  can  never 
be  removed.  Tar  water  should  be  perseveringly  administered.  Essence 
of  turpentine  in  doses  of  2  to  2|  drachms  per  day  in  electuary 
(adults),  creosote  in  doses  of  l^-  to  1^  drachms,  and  terpine  in 
doses  of  f  to  1  drachm  give  the  best  results,  and  produce  a  marked 
improvement. 


PSEUDO-MEMBRANOUS   BRONCHITIS.  339 


PSEUDO-MEMBRANOUS    BRONCHITIS. 

The  pseudo-membranous  forms  of  bronchitis,  formerly  termed 
"  croupal  or  di^jhtheritic  bronchitis/' are  rare.  They  develop  suddenly 
or  follow  pseudo-membranous  laryngitis.  Like  the  latter,  they  are  due 
to  a  specific  infection,  possibly  aided  by  accidental  causes. 

Their  causation  is  imperfectly  understood,  and  the}^  cannot  be  com- 
pared, still  less  homologated,  with  diphtheritic  disorders  in  man.  They 
are  characterised  by  the  formation  of  false  membranes,  which  develop  on 
the  mucous  surface,  mould  themselves  over  the  internal  surface  of  the 
large  bronchi,  and  ramify  throughout  the  bronchial  channels  like 
branches  of  trees.  They  are  of  greyish-yellow  colour,  and  appear  to  be 
formed  of  fibrin,  coagulated  albumen,  and  epithelial  debris  cemented 
together  with  mucus. 

Symptoms.  At  the  outset  these  pseudo-membranous  forms  of 
bronchitis  have  the  same  characters  as  acute  bronchitis,  which  at  the 
crisis  would  be  marked  by  the  expulsion  of  fragments  of  false  membrane 
by  coughing.  Most  frequently  it  seems  that  the  bronchitis  follows  its 
regular  course,  and  in  such  case  it  is  only  during  convalescence  or  a 
considerable  time  afterwards  that  the  membranes  begin  to  be  discharged 
during  paroxysms  of  coughing. 

The  patients  are  subject  to  intense  dyspnoea,  appear  about  to  suffo- 
cate, and  during  the  efforts  then  made  the  false  membranes  are  dis- 
charged in  the  form  of  half-organised  layers,  or,  on  the  other  hand,  in 
branched  masses,  resembling  twigs. 

The  dyspnoea  at  once  ceases.  Despite  the  development  of  these 
false  membranes  in  the  bronchi,  no  alarming  symptoms  are  produced, 
wdiich  is  explained  by  the  fact  of  the  false  membranes  being  adherent 
only  to  the  inner  surface  of  the  principal  conduits,  without  closing  or 
even  markedly  obstructing  them  or  the  smaller  passages  leading  to 
the  pulmonary  alveoli.  When,  however,  they  are  displaced,  violent 
reflex  spasms  are  produced  as  soon  as  the  fragments  approach  the 
larynx. 

Diagnosis.  The  diagnosis  rests  entirely  on  examination  of  the 
expectorated  material. 

So  far  as  the  prognosis  is  concerned,  it  is  less  grave  than  might  be 
supposed  from  the  symptoms.  The  gravity  arises  from  the  fact  that  this 
disease  has  a  certain  tendency  to  become  chronic. 

Treatment  scarcely  differs  from  that  of  ordinary  bronchitis.  Tar, 
creosote  in  doses  of  2^  to  5  drachms  given  in  oil ;  terpine  in  doses  of 
^  to  f  drachms  per  day  can  be  recommended.  Iodide  of  potassium  also 
has  certain  advantages. 

z  2 


840  LARYNX,   TRACHEA   AND   BRONCHI. 


VERMINOUS    BRONCHITIS    IN    SHEEP    AND    CATTLE    (hUSK,    HOOSE,    ETC.). 

Lambs,  3'Oung  sheep,  and  calves  sometimes  suffer  severely  from  infes- 
tation with  lung  worms,  which  set  up  great  irritation  in  the  bronchial 
passages,  leading  to  chronic  bronchitis.  The  animals  show  frequent 
attacks  of  paroxysmal  coughing,  during  which  some  of  the  parasites  may 
be  expelled.  The  irritation  produced  causes  serious  loss  of  condition, 
and  if  not  alleviated  may  lead  to  death.  The  parasite  of  the  sheep  is 
known  as  Strongylus  filaria  (sheep  lungworm),  that  of  the  calf  StromiyJm 
micrurus.  The  worms  are  from  2  to  4  inches  long,  whitish  in  colour, 
and  of  the  diameter  of  a  hat-pin. 

Treatment.  According  to  generally  accepted  views  among  veteri- 
narians and  zoologists,  it  is  a  comparatively  simple  matter  to  kill 
worms  in  the  bronchial  tubes,  and  a  number  of  cases  of  the  disease 
are  reported  in  literature  which  are  alleged  to  have  been  cured.  These 
views,  however,  are  open  to  very  serious  doubt. 

Neumann  (1892b,  pp.  590,  591,  593,  594)  summarises  the  subject  of 
treatment  as  follows  : — 

Two  different  procedures  in  treatment  are  pursued.  In  one,  sub- 
stances are  passed  into  the  digestive  canal,  which,  being  diffused  in  the 
blood,  are  believed  to  be  capable  of  attacking  the  worms  in  the  bronchial 
tubes.  With  this  view,  the  picrate  of  potash  (0*20  to  0*40  gram  per  head) 
is  given,  dissolved  in  thin  gruel  or  mucilage ;  creosote ;  oil  of  turpentine ; 
a  mixture  of  equal  parts  of  oil  of  turpentine  and  tincture  of  camphor — a 
teaspoonful  every  day  to  each  lamb  in  a  mucilaginous  fluid ;  a  mixture  of 
creosote  120  grams,  spirits  of  wine  500  grams,  and  water  700  grams — 
an  ordinary  spoonful  every  day  to  each  animal  ;  or  creosote  60  grams, 
benzine  300  grams,  water  2  litres — an  ordinary  spoonful  given  every  day 
for  eight  days  to  each  sheep.  Hall  states  he  has  successfully  employed 
prussic  acid  in  ten-drop  doses,  morning  and  evening. 

But  experience  has  shown  that,  while  such  treatment  is  troublesome 
to  carry  out,  its  efficacy  cannot  be  relied  upon. 

Success  is  more  certain  with  fumigations,  as  they  penetrate  directly 
to  the  worms,  stupefy  them,  and  induce  fits  of  coughing  that  cause  expul- 
sion. They  are  practised  in  buildings  from  which  all  forage  is  previously 
removed,  and  which  are  well  closed.  Into  these  the  diseased  [animals] 
are  introduced,  and  on  a  red-hot  shovel  are  placed  rags,  horns,  feathers, 
hair,  old  pieces  of  leather,  empyreumatic  oil,  tar,  juniper  berries, 
asafetida,  etc.  The  intensity,  duration,  and  number  of  these  fumiga- 
tions are  graduated  as  the  sheep  become  accustomed  to  them.  At  first 
once  a  day  may  suffice,  and  then  the  intensity  should  be  moderate  and 
the  duration  about  ten  minutes;  afterwards  two,  and  finally  three,  may 
be  given  during  the  day,  each  lasting  for  twenty  minutes.     Kowalewsky 


VERMINOUS    BRONCHITIS    IN   SHEEP  AND   CATTLE  (HUSK,  HOOSE,  ETC.).       341 

says  he  has  obtamed  very  good  results  from  shnilar  fumigations.  Fumi- 
gations with  chlorine,  sulphur,  and  sulphuret  of  mercury  or  cinnabar 
have  been  recommended,  but  they  are  dangerous. 

(Stephen  recommends  as  follows :  Put  about  forty  lambs  at  a  time 
into  an  air-tight  house,  and  place  tar,  sulphur,  and  turpentine  in  a  pot  of 
burning  coals,  suspended  by  a  chain  from  the  ceiling  and  brought  as 
near  to  the  heads  of  the  animals  as  possible  ;  the  fumes  are  to  be  allowed 
to  fill  the  house,  and  more  ingredients  are  added  as  required,  the  lambs 
being  kept  in  the  place  for  twenty-five  minutes  each  time,  and  the  process 
to  be  repeated  on  three  occasions.) 

Tracheal  injections  in  the  verminous  bron  diitis  of  calves  are  of  great 
utility  ;  but  for  a  flock  of  sheep  they  would  be  troublesome  and  difficult 
to  administer.  However,  Nieman,  has  successfully  employed  them  on 
384  sheep  belonging  to  several  small  owners.  He  used  a  solution  of  2 
parts  iodine  and  10  parts  iodide  of  potassium  in  100  parts  of  distilled 
water.  This  fluid  was  mixed,  in  equal  parts,  with  oil  of  turpentine,  and 
made  into  an  emulsion  with  olive  oil ;  each  sheep  received  5  to  8 
grams  of  the  mixture,  and  the  number  of  the  injections  varied  according 
to  the  gravity  of  the  disease — from  two  to  three  at  two  days'  interval. 
The  worms  were  killed  and  expelled  during  the  paroxysms  of  coughing, 
and  the  bronchitis  was  modified. 

The  medical  treatment  should  be  assisted  by  very  nourishing  food, 
and  by  bitter,  stimulating,  and  ferruginous  tonics,  which  arouse  the 
digestive  functions  and  allow  those  animals  which  are  least  exhausted  to 
reach  the  period  of  elimination  of  the  parasites. 

At  the  commencement  of  any  kind  of  treatment  it  is  well  to  have  an 
examination  of  the  flock,  with  the  object  of  sending  the  worst  cases  to 
the  butcher. 

The  same  medicaments  have  been  employed  in  treating  this  malady 
in  calves  as  in  that  of  sheep,  and  no  better  results  have  been  obtained. 
Numann  and  Janne  have,  however,  been  successful  with  asafetida  (30 
grams),  Chabert's  empyreumatic  oil  (60  grams),  and  a  mucilaginous 
decoction  (500  grams) — a  spoonful  of  this  mixture  being  given  in  a  half 
litre  of  milk,  and  the  treatment  continued  for  about  a  month. 

The  results  are  less  uncertain  if  the  worms  lodged  in  the  bronchial 
tubes  are  directly  acted  upon,  either  by  means  of  injections  of  the  same 
kind  as  those  employed  for  sheep,  or  fluid  medicaments  introduced 
directly  into  the  bronchi. 

Eead  says  he  has  cured  calves  worn  down  almost  to  skeletons  by 
verminous  bronchitis  by  the  following  procedure  :  The  head  of  the  calf 
is  slightly  elevated,  and  about  2  drachms  of  ether,  chloroform,  oil  of 
turpentine,  or  rectified  oil  of  amber — single  or  combined — are  poured 
into   each  nostril  and  allowed   to  vaporize  there ;  it  will  then,  by  the 


342  LARYNX,  TRACHEA  AND  BRONCHI. 

respiration,  be  carried  into  the  air  passages,  and  thus  destro.y  the  filarire. 
In  some  cases  it  must  be  repeated  two  or  three  times,  but  once  has 
frequently  the  desired  effect. 

The  method  of  treatment  by  intra-traeheal  injection,  introduced  by 
Levi,  of  Pisa,  has  yielded  very  satisfactory  results.  Levi  has  been  com- 
pletely successful  with  a  sheep.  Eloire  has  employed  it  in  sixteen  calves 
affected  with  the  disease,  and  all  were  cured.  He  used  the  following 
mixture :  Black  poppy  oil,  100  parts  ;  oil  of  turpentine,  100  parts  ;  car- 
bolic acid,  2  parts  ;  purified  cade  oil,  2  parts.  Each  calf  received  10 
grams  of  this  mixture  daily  for  three  days. 

The  injection,  which  should  be  given  slowly,  is  followed  by  a  fit  of 
coughing,  and  the  expired  air  has  the  odour  of  turpentine.  This  treat- 
ment has  also  been  successful  at  Milan.  Similar  favourable  results  have 
followed  Button's  treatment  of  eight  calves,  some  of  which  were  in  the 
last  stage  of  verminous  bronchitis.  He  employed  a  mixture  of  oil  of 
turpentine,  tincture  of  opium,  pure  carbolic  acid,  and  water — the  oil 
of  turj^entine  forming  one-half  of  the  mixture.  The  dose  was  ^  an 
ounce,  and  in  the  serious  cases  this  was  given  every  day  for  three  days, 
and  in  other  cases  every  second  or  third  day.  Kriwonogow  has  likewise 
cured  twenty- two  calves  by  giving  each  of  them  two  tracheal  injections  of 
8  grams  of  the  following  mixture  :  Essence  of  cloves  and  oil  of  turpen- 
tine, 3()0  parts  of  each  ;  carbolic  acid  and  olive  oil,  30  parts  of  each. 

(Williams  speaks  highly  of  the  administration  of  prussic  acid. 
Penhale  gives — by  intra-tracheal  injection,  and  slowly — oil  of  turpentine 
2  drams,  carbolic  acid  20  minims,  and  chloroform  ^  a  dram.) 


CHAPTER    IV. 
LUNGS    AND    PLEURA. 

PULMONARY    CONGESTION. 

Besides  passive  congestions  of  the  lung,  which  it  is  unnecessary  to 
descrihe  here,  and  which  result  from  cardiac  or  pericardiac  affections  or 
the  compression  of  important  vessels,  there  sometimes  occur,  particularly 
among  young  animals,  cases  of  active  congestion  of  the  lung.  Such  cases 
are  produced  by  over-exertion  on  the  part  of  animals  which  have  escaped 
from  control  or  have  been  chased  by  dogs. 

They  are  most  common  in  animals  usually  kept  in  stables,  but  which 
have  accidentally  escaped,  or  in  very  fat  animals. 

Dyspnea  and  cough  are  the  chief  symptoms.  The  animals  stop  as 
tliough  exhausted,  extend  their  neck  and  head,  dilate  their  nostrils  and 
thrust  their  limbs  out  on  either  side  of  the  body,  while  at  the  same  time 
they  appear  in  a  condition  of  terrible  distress. 

The  respiration  is  rapid  and  short,  the  patient  can  scarcely  breathe, 
and  asphyxia  seems  imminent.  On  auscultation  it  seems  that  the 
respiratory  murmur  has  disappeared  over  almost  the  entire  extent  of 
the  lung. 

Death  may  occur  very  quickly. 

The  diagnosis  is  extremely  easy,  provided  that  the  history  is  known. 

The  prognosis  is  grave. 

One  of  the  most  successful  methods  of  treatment  consists  in  free 
bleeding.  In  a  great  majority  of  cases  this  causes  the  symptoms  to 
abate  as  though  by  enchantment.  Cutaneous  stimulation  by  mustard 
and  similar  irritants,  as  well  as  ablutions  of  cold  water,  are  useful.  The 
animal  should  be  placed  in  a  very  airy  spot. 

SIMPLE  PNEUMONIA. 

History.  Veterinary  surgeons  have  long  been  divided  in  opinion  on 
the  question  whether  simple  pneumonia  occurs  in  animals  of  the  bovine 
species.  Whilst  some  affirm  it,  others  think  that  all  lesions  of  the  lung 
in  the  ox,  apart  from  pneumonia  due  to  foreign  bodies,  should  be 
regarded  as  of  the  nature  of  peripneumonia. 


344  LUNGS   AND    PLEVRM. 

Some  ten  years  ago  two  veterinary  surgeons  of  the  department  of  the 
Aisne,  Coulon  and  Ollivier,  practising  in  a  district  where  peripneumonia 
rages,  made  some  extremely  interesting  ohservations  on  pneumonia  in 
the  ox.  Their  ohject  was  to  distinguish  between  contagious  peri- 
pneumonia and  simple  pneumonia  during  life,  simple  pneumonia  having 
formerly  been  regarded  as  a  non-contagious  peripneumonia.  Despite 
the  rather  unfavourable  conditions  in  which  ordinary  practitioners  are 
frequently  placed,  these  gentlemen  performed  a  work  of  great  value. 
The  facts  which  point  to  the  occurrence  of  simple  pneumonia  are  as 
follows  : — 

The  disease  is  not  contagious.  One  may  allow  affected  animals  to 
mix  with  normal  subjects  without  the  disease  being  communicated. 
Pulmonary  exudate  from  cases  of  simple  pneumonia  can  be  injected 
into  the  dewlap  and  hind  quarters  of  young  and  adult  animals,  with- 
out pathological  results. 

The  lesions  and  course  of  simple  pneumonia  entirely  differ  from 
those  of  peripneumonia. 

Causation.  Simple  pneumonia  is  not  common,  and  only  occurs 
quite  exceptionally  in  fat  stock,  or  in  milch  cows  kept  in  stables  at  a 
regular  temperature,  as  in  the  north  of  France  and  near  Paris. 

It  occurs  most  commonly  in  working  animals,  which  are  exposed  to 
variations  in  temperature  and  to  chills.  By  causing  vascular  disturb- 
ance, chill  favours  microbic  infection  and  visceral  inflammation.  Trasbot 
has  described  the  case  of  an  ox  which,  after  having  worked  hard,  and 
whilst  freely  sweating,  was  left  exposed  to  the  wind  under  a  shed  for 
about  three  hours.  This  animal  contracted  unilateral  pneumonia  the 
following  day. 

Coulon  and  Ollivier  have  seen  the  disease  in  animals  living  in  damp, 
low-lying  valleys,  or  valleys  exposed  to  the  north  wind,  which  are  ex- 
posed in  consequence  to  great  variations  in  temperature. 

The  symptoms  follow  almost  the  same  course  as  in  the  horse,  and 
one  may  distinguish  three  periods : — 

I.  Period  of  onset.  The  symptoms  which  mark  the  onset  of  the 
disease  are  moderate  fever,  which  progressively  increases,  and  accelera- 
tion of  respiration  and  of  circulation.  The  number  of  the  respiratory 
movements  rises  to  twenty  or  twenty-five  per  minute,  those  of  the 
pulse  to  fifty,  sixty,  or  eighty.  The  conjunctiva  becomes  injected,  and 
then  of  a  yellow  tint.  At  this  period  the  appetite  never  disappears 
completely,  rumination  is  regular,  and  there  is  neither  tympanites  nor 
colic. 

These  general  symptoms,  which  are  not  of  special  significance,  are 
supplemented  by  more  precise  local  symptoms — an  abortive,  difficult  and 
painful,  cough  which  is  easily  induced,  and  a  whitish  discharge.     The 


SIMPLE    PNEUMONIA.  345 

rusty  expectoration  which  is  characteristic  of  simple  pneumonia  in  the 
horse  and  in  man  has  never  heen  observed. 

Percussion  discloses  partial  dulness,  usually  on  one  side,  in  the  lower 
region  of  the  chest :  the  respiratory  murmur  in  this  region  is  ascertained 
by  auscultation  to  have  diminished,  whilst  in  the  upper  part  and  also  on 
the  opposite  side  the  respiratory  murmur  is  increased. 

II.  Period  of  exacerbation.  This  period  is  characterised  by  accen- 
tuation of  all  the  symptoms:  the  temperature  rises,  and  may  attain 
104°  Fahr. ;  the  submaxillary  artery  is  tense;  the  dulness  becomes 
more  marked,  whilst  crepitant  and  mucous  rales  are  heard.  In  the 
portions  still  unattacked  the  function  of  the  lung  is  exaggerated  in 
order  to  make  up  for  the  defect  of  the  diseased  parts,  and  the  respira- 
tion becomes  juvenile. 

The  appetite,  which  previously  had  been  maintained,  diminishes  con- 
siderably, without,  however,  entirely  disappearing,  and  intense  thirst  sets 
in,  as  a  consequence  of  the  fever. 

III.  Period  of  crisis.  The  general  symptoms  remain  stationary  for 
four  or  five  days ;  the  respiration,  which  is  always  affected,  sometimes 
becomes  as  rapid  as  thirty  to  forty  per  minute;  the  tubal  souffle  which 
invariably  occurs  in  pneumonia  of  the  horse  is  not  always  clearly 
audible. 

Terminations.  (1.)  Eesolution. — This  is  indicated  by  the  attenuation 
of  all  the  symptoms  and  the  disappearance  of  fever,  which  gradually 
sinks  from  105°  to  101°  Fahr.  The  respiratory  movements  become  fuller 
and  fewer  in  number,  the  pulse  slower,  and  the  artery  softer  and  more 
compressible.  The  cough  changes  its  character,  is  stronger,  more 
sonorous  and  prolonged,  and  is  accompanied  by  the  free  discharge  of 
muco-pus.  The  dulness  descends,  and  the  tubal  souffle,  if  previously 
existing,  is  replaced  by  the  returning  crepitant  rale.  In  general  the 
disease  runs  its  course  in  eight  to  ten  days  in  young  and  in  fourteen 
to  fifteen  days  in  aged  subjects. 

(2.)  Death  by  asphyxia  is  almost  the  only  fatal  termination  of 
pneumonia  in  the  ox.  It  occurs  in  one-third  to  one-fourth  of  the 
subjects  attacked.  Its  approach  is  announced  by  a  deep  mahogany- 
red  coloration  of  the  conjunctiva.  The  pulse  becomes  very  rapid,  100 
to  110  per  minute,  thready,  small,  and  almost  imperceptible,  whilst  the 
beating  of  the  heart  is  strong  and  tumultuous.  Eespiration  is  rapid  and 
very  laboured  (50  to  70  per  minute).  The  animal's  attitude  is  typical; 
it  stands  with  its  limbs  thrust  out,  its  head  extended,  its  nostrils 
dilated,  and  its  mouth  half  open,  discharging  foamy  and  viscous  saliva. 
Througiiout  the  greater  portion  of  the  lung  gurgling  sounds  and 
crepitant  mucous  rales  can  then  be  detected. 

(3.)  Cases    ending    in   gangrene    and    suppuration    are    excessively 


346  LUNGS   AND   PLEURA. 

rare,    and    others    resulting    in    chronic    pneumonia    have    not    been 
authoritatively  described. 

Pneumonia  is  distinguished  from  broncho-pneumonia  by  the  exist- 
ence of  dulness  at  the  period  of  crisis,  whilst  in  the  case  of  broncho- 
pneumonia this  period  is  only  marked  by  partial  dulness,  which  is  even 
then  sometimes  slight.  Moreover,  broncho-pneumonia  usually  develops 
much  more  slowly. 

The  disease,  then,  is  distinguished  from  peripneumonia  by  the 
following  points :  — 

(«)  By  the  character  of  the  temperature  curve,  which  is  regular  in 
pneumonia,  only  attaining  its  highest  point  at  the  period  of  crisis,  whilst 
in  peripneumonia  it  ascends  suddenl}^  and  presents  sudden  oscillations. 

(h)   The  a]>petite  remains,  although  diminished. 

(f)  Sensitiveness  in  the  region  of  the  ribs  is  but  feebly  marked,  or  is 
entirely  absent,  simple  pneumonia  not  being  accompanied  by  pleuris3\ 

(d)  The  dewlap  never  shows  ci'dema,  a  symptom  which  usually 
accomj)anies  the  period  of  crisis  in  peripneumonia,  when  the  jugular 
veins  and  the  anterior  vena  cava  are  compressed. 

{(')  These  signs  alone  are  almost  sufficient  on  which  to  base  the 
diagnosis,  but  tliey  are  often  supplemented  by  two  others,  of  some 
what  less  importance  (for  in  exceptional  cases  they  may  also  be 
observed  in  simple  pneumonia),  viz. — the  absence  in  most  instances 
of  a  membranous  sound,  and  of  a  well-marked  souffle. 

Prognosis.  Two-thirds  of  the  cases  recover.  This  proportion  nn'ght 
be  increased  if  the  veterinary  surgeon  were  called  in  at  the  beginning. 

Lesions.  Post-mortem  examination  reveals  neither  pleural  exudate 
nor  pleural  lesions.  The  lung  is  large  and  of  increased  weight,  hepatised 
along  its  lower  borders,  and  congested  in  its  upper  part. 

The  sero-haemorrhagic  infiltration  of  the  interlobular  spaces  varies, 
according  to  the  region  examined :  the  upper  regions  are  engorged  and 
black,  owing  to  capillary  hemorrhages  and  blood  clots,  which  completely 
surround  the  pulmonary  lobule,  the  latter  being  violet  or  brownish-red 
in  colour.  In  the  hepatised  portions  the  lobules  are  of  a  washed-out 
reddish  tint,  and  the  interspaces  of  a  whitish  colour. 

The  bronchi  are  filled  with  frothy,  whitish  mucus;  the  small  bronchi 
sometimes  contain  fibrous  concretions  and  the  mucous  membrane  is 
injected,  and  may  be  destroyed  in  places.  The  bronchial  lymphatic 
glands  are  enlarged,  congested,  and  contain  small  haemorrhages. 

It  is  important  in  making  a  post-mortem  examination  to  be  able  to 
distinguish  pneumonia  from  peripneumonia.  This  is  comparatively 
easy  if  one  bears  in  mind  that  in  the  latter  pleurisy  always  exists, 
that  the  interlobular  connective  tissue  spaces  are  always  greatly  dis- 
tended with  a  citrine-coloured  serosity,  that   on  section    the  peripneu- 


PNEUMONIA    DUE    TO    FOREIGN    BODIES— MECHANICAL    PNEUMONIA. 


347 


monic  lung  resembles  a  mosaic ;  and  that,  finally,  the  course  of 
hepatisation  is  centripetal,  the  inflammation  commencing  at  the  peri- 
phery of  the  lobule,  and  progressively  extending  to\Yards  the  centre.  In 
pneumonia,  on  the  contrary,  pleurisy  is  always  absent;  the  interlobular 
connective  spaces  are  only  distended  slightly,  if  at  all,  and  always  con- 
tain a  brownish-red  serosity :  the  course  of  hepatisation  is  centrifugal ; 
it  commences  in  the  pulmonary  alveoli,  and  extends  towards  the  peri- 
phery and  the  interlobular  divisions.  The  following  table  gives  a 
resume  of  the  other  differences  between  the  two  diseases: — - 


Peripnenuionia. 

ffidema  of  the  dewlap. 

Pleural  exudate. 

Centripetal  lobular  hepatisation. 

Extreme  infiltration  of  the  interlobular 
connective  tissue  spaces  (priniar}'  yellow 
infiltration). 


Pneumonia. 

No  oedema  of  the  dewlap. 

No  i^leural  exudate. 

Ascending    centrifugal     lobar    hepatisa- 

tion. 
Moderate  infiltration  of  the  interlobular 

connective    tissue    spaces    (secondary 

reddish-brown  infiltration). 


Treatment.  Good  hygiene,  regular  ventilation,  moderate  warmth, 
and  the  administration  of  tepid  drinks  facilitate  recovery. 

Certain  German  authors  recommend  cold  compresses  to  the  thorax, 
douches,  and  cold  enemata  in  pneumonia.  We  do  not  think  that  such 
treatment  has  proved  very  successful,  although  it  has  been  well  tried. 

The  classic  treatment  commences  with  moderate  bleeding,  the  free 
application  of  mustard  to  the  sides,  the  application  of  moxas,  frictions 
with  antimonial  or  blister  ointment,  and  the  administration  of  draughts 
containing  2  to  2J  drachms  of  tartar  emetic  per  day,  or  considerable 
doses  of  alcohol ;  and  this  treatment  seems  to  have  given  the  best  re- 
sults. Antithermic  agents,  like  acetanilide,  phenacetin  and  quinine  sul- 
phate, are  too  costly  to  be  greatly  used  in  bovine  medicine.  Salicylate  of 
soda  is  preferable. 

In  order  to  assist  circulation,  support  the  tone  of  the  heart  and  avoid 
engorgement  of  the  lung  and  asphyxia ;  digitalis  should  be  given  in  doses 
of  f  to  1  drachm  per  day,  or  digitalin  in  subcutaneous  injections  of  5  to  6 
milligrammes,  continued  for  five  or  six  days.  Finally,  iodide  of  potassium 
may  be  given  in  doses  of  1  to  1^  drachms,  to  reduce  inflammation  and  as 
an  expectorant. 


PNEUMONIA    DUE    TO    FOREIGN    BODIES    MECHANICAL 
PNEUMONIA. 

It  may  happen  that  in  examining  a  patient  pneumonia  is  diagnosed 
under  circumstances  which  seem  to  forbid  its  being  regarded  as  simple 
or  primary.     This  may  be  explained  by  the  fact  that  ruminants  are  very 


348  LUNGS    AND   PLEUR^:. 

apt  to  suffer  from  pneumonia  produced  by  foreign  bodies.  The  lung  may 
be  penetrated  either  by  some  sharp  object  making  its  way  forwards  from 
the  rumen  or  recticukim  or  by  Hquid  or  soHd  material  passing  into  the 
trachea.  These  are  two  common  methods  by  which  this  form  of  pneu- 
monia is  produced. 


PNEUMONIA    DUE    TO    THE    MIGRATION    OF    FOREIGN    BODIES    FROM 
THE    RETICULUM. 

Causation.  The  conditions  under  which  food  is  swallowed  by  rumi- 
nants after  preliminary  mastication  permit  indigestible  objects,  such  as 
stones,  fragments  of  wood,  nails,  needles,  bits  of  iron  wire,  etc.,  to  enter 
the  rumen,  whence  they  reach  the  reticulum  in  consequence  of  peristaltic 
movements.  Sharp,  perforating  objects,  like  needles  or  fragments  of  iron 
wire,  penetrate  the  walls  of  the  gastric  compartments,  and,  impelled  by 
the  movements  of  these  organs,  pass  through  the  intervening  tissues, 
usually  in  the  direction  of  the  heart.  Under  conditions  which  cannot 
precisely  be  defined,  these  foreign  bodies  make  their  way  towards  the 
pleural  cavity  (usually  the  right,  in  consequence  of  the  situation  of  the 
reticulum),  traverse  the  diaphragm,  and  directly  penetrate  tbe  base  of 
the  lung. 

As  the  migrating  object  is  usually  infected,  its  passage  through  the 
diaphragm  always  produces  a  localised  patch  of  diaphragmatic  pleurisy. 
Although  possible,  it  is  only  rarely  that  the  pleural  sac  becomes  generally 
infected,  or  that  rapidly  fatal  septic  pleurisy  is  set  up.  Usually  the 
localised  pleurisy  causes  the  base  of  the  lung  to  become  adherent  to 
the  anterior  surface  of  the  diaphragm.  The  foreign  body  continuing 
its  movements,  passes  into  the  lung,  and  there  sets  up  pneumonia. 

Symptoms.  When  the  practitioner  is  first  consulted  he  often  finds 
only  indications  of  the  crisis  period  of  a  localised  pneumonia  at  the  base 
of  the  affected  lung.  The  symptoms  include  fever,  accelerated  breathing, 
moaning,  loss  of  appetite,  cough  without  discharge,  dulness  over  the  base 
of  the  lung  on  percussion,  disappearance  of  the  respiratory  murmur  in 
the  dull  area,  soufile  opposite  the  inferior  bronchi,  and  normal  or  juvenile 
respiration  towards  the  front,  i.e.,  in  the  anterior  lobe,  and  sometimes 
in  the  cardiac  lobe. 

The  temptation  under  such  circumstances  is  to  deliver  a  diagnosis 
of  simple  pneumonia  with  prognosis  of  probable  recovery.  It  should  be 
remembered,  however,  that  in  all  cases  of  basilar  pneumonia  without 
affection  of  the  anterior  lobes  there  is  a  considerable  chance  of  the  con- 
dition being  due  to  the  presence  of  a  foreign  body.  On  more  careful 
examination  it  is  found  that  the  intercostal  spaces  opposite  the  affected 
region  are  very  sensitive,  and  that  the  circle  of  the  hypochondrium  'is 


MIGRATION    OF    FOREIGN    BODIES    FROM    THE    RETICULUM.  349 

con-espondiiigly  sensitive.  The  owner,  moreover,  almost  always  informs 
the  iDractitioner  that  for  several  weeks  his  animal  has  coughed,  shown 
tympanites,  diminished  appetite,  etc. 

Compression  of  the  roots  of  the  corresponding  diaphragmatic  nerve 
at  the  base  of  the  neck  always  produces  coughing. 

These  symptoms  rarely  accompany  the  development  of  simple  pneu- 
monia. Furthermore,  the  course  of  this  accidental  pneumonia  is  en- 
tirely different.  Instead  of  developing  regularly  according  to  the  above- 
described  cycle,  pneumonia  due  to  foreign  bodies  develops  slowly,  and 
only  becomes  well  defined  after  several  weeks,  whilst  its  tendency  is  to 
grow  more  and  more  aggravated.  The  zone  of  dulness  extends  both  in 
a  forward  and  upward  direction.  The  souffle  extends  forwards.  Auscul- 
tation and  palpation  sometimes  reveal  the  formation  of  an  abscess  or 
local  gangrene  ;  while  there  is  slight  oedema  of  the  wall  of  the  chest,  as 
well  as  a  gargling  sound  at  the  moment  when  the  lung  is  displaced, 
high  fever,  intensely  coloured  urine,  and  very  marked  leucocytosis,  etc. 
Death  is  inevitable,  and  when  gangrene  exists  it  sometimes  occurs 
suddenly. 

Diagnosis.  The  diagnosis  is  based  on  the  information  furnished  with 
regard  to  the  course  of  the  disease,  the  localisation  of  the  hepatised  zone, 
and  the  progressive  character  of  the  affection. 

The  diagnosis,  nevertheless,  is  always  a  little  doubtful,  but  may  be 
so  far  assured  as  to  attain  the  position  of  a  quasi-certainty. 

Prognosis.     The  prognosis  is  unequivocal. 

Treatment.  No  practical  treatment,  either  to  extract  the  foreign 
body  or  to  combat  the  special  pneumonia  which  it  has  produced,  can 
be  attempted.  All  the  interlobular  connective  layers  and  the  lobules 
themselves  are  invaded  by  various  micro-organisms  carried  by  the  foreign 
body.  Numerous  fragments  of  tissue  serve  as  centres  of  suppuration  and 
gangrene,  and  the  only  chance  would  lie  in  attempting  resection  of  the 
lung.  Such  intervention  has  no  practical  interest  in  veterinary  surgery. 
It  is  true  that  when  the  existence  of  an  abscess  is  suspected,  an  aseptic 
exploratory  puncture  may  be  made,  and,  in  the  event  of  the  diagnosis 
being  so  far  confirmed,  the  abscess  might  be  opened  through  an  inter- 
costal space.  Under  such  circumstances,  however  deep  the  point  of 
penetration  of  the  foreign  body,  the  development  of  the  resulting  abscess 
causes  local  pleurisy  and  adherence  between  the  pleura  and  lung,  so 
that  there  is  no  immediate  danger  of  producing  purulent  pleurisy  and 
pneumo-thorax.  If  small  the  foreign  body  might  possibly  be  discharged 
through  the  passage  thus  afforded. 

In  practice  the  best  plan  is  to  recommend  slaughter  as  soon  as 
the  diagnosis  becomes  certain,  provided  that  the  meat  can  still  be 
utilised. 


350  LUNGS   AND    PLEURA 

PNEUMO'MYCOSIS    DUE    TO    ASPERGILLL 

The  term  pneumo-mycosis,  or  pulmonary  aspergillosis,  is  used  to  denote 
a  condition  due  to  the  growth  in  the  respiratory  apparatus  of  a  fungus 
of  the  order  aspergillus  (family,  Pci-'niporiw  ,•  sub-order,  Pe}-isp())-iace(e ; 
order,  Ascomycetes). 

In  ruminants,  as  in  all  other  animals,  pulmonary  aspergillosis 
occurs  accidentally,  and  may  often  pass  unperceived,  in  spite  of  the 
indications  given  by  Lucet  and  Bournay  regarding  its  development  and 
symptoms. 

It  seems  most  frequently  to  be  caused  by  A.yx'njiUiis  nif/er  and  Asper- 
(jillus  fumigatns,  particularly  by  the  latter,  ^Yhich,  according  to  Eenon's 
work,  also  appears  to  be  the  most  pathogenic.  It  only  develops  in  animals 
whose  respiratory  apparatus  is  injured  and  is  the  seat  of  such  lesions  as 
those  of  chronic  bronchitis,  bronehi-ectasis,  and  of  parasitic  lesions 
or  those  containing  cavernous  spaces  resulting  from  abscess  formation, 
etc.,  etc. 

The  fungi,  or  more  properly  the  spores,  which  have  accidentally 
jjenetrated  into  the  respiratory  channels  germinate  and  develop  in  the 
pathological  dilatations,  causing  disseminated  areas  of  pneumonia  and 
some  mechanical  disturbance,  but  not  producing  intoxication  by  liberating 
toxins. 

Causation.  Infection  occurs  through  the  air  passages,  in  conse- 
quence of  the  inspiratory  current  carrying  spores  of  the  fungi  into 
the  ramifications  of  the  bronchi,  where  they  develop  if  the  soil  is 
favourable.  Development  is  favoured  if  the  animals  exposed  to  con- 
tamination are  in  bad  condition,  or  if,  as  sometimes  happens,  the  walls 
of  the  stables  are  not  kept  clean,  and  are  covered  with  various  forms 
of  fungi. 

Prolonged  feeding  on  musty  fodder  may  also  favour  respiratory  in- 
fection ;  but  it  seems  highly  improbable  that  under  ordinary  conditions 
infection  can  occur  through  the  digestive  tract.  Infection  of  the  lung 
must  also  be  regarded  as  exceptional,  if  one  bears  in  mind  the  frequency 
with  which  oxen  are  fed  on  musty  or  mildewed  fodder  and  the  small 
numl^er  of  accidents  recorded. 

Symptoms.  The  symptoms  are  obscure,  and  pulmonary  aspergillosis 
is  often  only  discovered  on  post-mortem  examination.  A  cough  is  the 
chief  symptom.  It  is  dry  at  first.  Afterwards  it  becomes  spasmodic 
and  frequent. 

Respiration  is  difficult,  dyspnceic,  efiected  only  with  effort,  and  some- 
times even  discordant.     Expiration  is  sighing. 

Percussion  reveals  zones  of  partial  or  complete  dulness  when  the 
lesions   are   near   the   surface   of   the   lung,    which,    however,   is   rare. 


GANGRENOUS    BRONCHO-PNEUMONIA   DUE   TO    FOREIGN    BODIES.       851 

Bournay  has  noted  the  occurrence  of  a  musical  sound  resembhng  that 
obtained  by  tappmg  a  small  crystal  or  glass  bell. 

Auscultation  is  said  to  reveal  rough  or  sibilant  rales,  but  as  the 
lesions  occur  only  in  animals  whose  respiratory  apparatus  has  already 
been  impaired,  it  is  difficult  to  offer  an  opinion  on  the  subject. 

These  signs  are  invariably  accompanied  by  a  certain  amount  of  general 
ilhhealth,  wasting,  and  irregularity  of  appetite  and  of  rumination. 

On  post-mortem  examination  the  lung  of  the  affected  animal  appears 
strewn  with  nodules,  varying  in  size  between  a  hazel-nut  and  a  walnut. 
On  section,  Bournay  claims  to  have  found  a  wall  or  fibrous  shell 
covering  a  greenish  cryptogamic  growth,  in  the  centre  of  which  was  a 
yellowish,  sharply  defined  kernel  formed  of  masses  of  fungi  {MfjceUnin, 
sterigmata  and  spores).  In  cases  of  rapid  development,  the  pulmonary 
tissue  around  the  parasitic  lesion  is  completely  hepatised. 

Diagnosis.  Diagnosis  is  impossible  without  recourse  to  microscopic 
examination  of  the  discharge.  This  examination,  which,  however,  is 
somewhat  difficult,  may,  after  staining,  result  in  the  detection  of  debris 
of  the  mycelial  filaments  and  of  spores,  with  or  without  bacilli  of  tuber- 
culosis. The  diagnosis  as  regards  fungi  can  only  be  assured  by  prei)aring 
cultures. 

Prognosis.  The  prognosis  is  grave,  because  the  disease  is  always 
superadded  to  lesions,  which  of  themselves  would  justify  a  sombre  view. 

Treatment.  In  consequence  of  the  small  number  of  observations  pub- 
lished and  the  difficulty  in  diagnosis,  no  rational  treatment  has  hitherto 
been  laid  down.  From  a  purely  theoretical  standpoint,  fumigations  with 
tar  and  essence  of  turpentine  and  the  inhalation  of  carbolic  sj^ray  have 
been  recommended.  Life  in  the  open  air  would,  without  doubt,  be 
equally  or  more  efficacious.  Preventive  treatment  consists  in  with- 
holding musty  fodder  and  keeping  the  stables  clean. 

GANGRENOUS    BRONCHO-PNEUMONIA    DUE    TO    FOREIGN 
BODIES. 

Foreign  bodies  which  find  their  way  into  the  trachea  instead  of 
the  oesophagus  provoke  in  most  cases  broncho-pneumonia,  which  very 
rapidly  terminates  in  gangrene  and  death. 

Causation.  Forced  feeding  of  sick  animals  which  have  lost  their 
appetite  is  one  of  the  principal  causes  of  this  grave  condition.  In 
order  to  administer  food  such  as  mashes,  gruel,  hay  tea,  etc.,  the  ox- 
herds have  a  bad  habit  of  lifting  the  entire  head  and  drawing  forward 
the  tongue  whilst  they  pour  the  concoctions  into  the  animal's  mouth. 
The  liquid  cannot  then  be  divided  into  portions,  deglutition  in  the 
pharynx  is  badly  effected,  and  the  substances  administered  find  their 


352  LUNGS   AND   PLEUR.E. 

way  partly  into  the  larynx  and  partly  into  the  oesophagus.  In  the  case 
of  astringent,  hitter,  or  highly  stimulating  drugs,  a  similar  accident  may 
he  caused  h}^  spasm  of  the  pharynx  or  cesophagus,  where  the  tongue  has 
not  heen  left  free  and  excessive  quantities  have  heen  given. 

Again,  during  the  course  of  diseases  complicated  with  paralysis  of  the 
phar^aix  (coAV-pox,  parturient  apoplexy),  obstruction  of  the  pharynx  and 
oesophagus  (tympanitic  indigestion),  intense  pharyngeal  dysphagia  (foot- 
and-mouth  disease),  etc.,  the  risk  of  broncho-pneumonia  due  to  foreign 
bodies  is  much  greater  still.  It  may  even  occur  spontaneously  in  animals 
in  the  enjoyment  of  complete  freedom  (foot-and-mouth  disease). 

Lastly,  cases  of  broncho-pneumonia  have  been  described  as  a  conse- 
quence of  inhaling  foreign  bodies,  when  the  animals  are  fed,  for  example, 
with  meal  made  from  undecorticated  cotton-seed.  Under  such  circum- 
stances the  lesions  produced  are  similar  to  those  of  pneumoconiosis  in  man 
(the  chronic  forms  of  pneumonia  of  miners,  charcoal-burners,  quarrymen, 
stonemasons,  etc.). 

Symptoms.  The  symptoms  of  gangrenous  broncho-pneumonia 
become  apparent  immediately  after  the  foreign  body  has  entered  the 
trachea.  They  commence  with  a  violent,  spasmodic  cough,  produced 
by  reflex  action,  which  in  its  turn  is  due  to  the  laryngeal  mucous  mem- 
brane having  l)een  touched.  But  this  cough  is  now  too  late  to  be  of  use, 
for  the  food,  drug  or  liquid  has  passed  into  the  depths  of  the  trachea, 
and  cannot  be  ejected.  The  cough  soon  ceases,  and  the  animals  may 
even  return  to  their  food.  These  appearances,  however,  are  deceptive,  for 
twelve,  twenty-four  or  forty-eight  hours  later  the  cough  reappears,  whilst 
appetite  diminishes.  The  attacks  of  coughing  are  succeeded  by  the  dis- 
charge of  a  greyish  or  reddish-grey  offensively  smelling  material ;  respira- 
tion becomes  more  rapid,  the  heart's  action  violent,  and  the  temperature 
rises  to  103^  or  even  105°  Fahr.  (89-5  to  40-5°  C). 

The  patients  soon  refuse  all  solid  food,  and  if  the  chest  is  then 
examined  by  percussion  one  finds  partial  dulness,  rarely  simple  dulness, 
over  the  cardiac  lobes  opposite  the  point  where  the  girth  passes.  The 
partial  dulness  may  rise  to  a  varying  height  on  both  sides ;  sometimes 
it  is  confined  to  one  side. 

On  auscultation  the  respiratory  murmur  in  the  upper  two  thirds  of 
the  lung  appears  exaggerated  on  both  sides,  and  is  found  to  have 
greatly  diminished,  or  disappeared  altogether  in  the  inferior  zone. 

Auscultation  through  the  scapula  almost  always  shows  that  the 
anterior  lobes  are  affected ;  but,  at  all  events,  in  the  examinations  we 
have  made,  checked  by  post-mortem  examination,  the  cardiac  lobes  have 
always  proved  to  l)e  most  affected,  a  fact  attributable  to  the  direction  of 
the  principal  bronchi.  The  lower  portion  of  the  posterior  lobes  may 
also  1)6  affected,  but   this  is  rarer.     All  the  lower  zone  is  irregularly 


GANGRENOUS    BRONCHO-PNEUMONIA    DUE   TO    FOREIGN   BODIES.      353 

hepatised,  and  on  auscultation  one  hears  large  moist  rales,  whilst 
respiration  sometimes  appears  of  a  blowing  character,  and  divided  by 
a  pause,  but  there  is  no  tubal  souffle.  If  the  patient  survive  for  a 
certain  time,  the  sounds  heard  on  auscultation  undergo  change;  gurgling 
noises  and  sometimes  true  cavernous  souffles  are  heard,  as  a  result  of 
suppuration  in  the  bronchi  and  gangrene  of  one  or  more  areas  in  the 
lung.  Diffuse  gangrene  is  rare,  and  the  inferior  zone  is  usually  the  only 
portion  affected. 

During  this  phase  the  expired  air  has  an  aljsolutely  characteristic 
gangrenous  odour. 

Death  occurs  by  asphyxia  and  intoxication,  but  some  animals  hold 
out  for  a  fortnight  and  more. 

Lesions.  Post-mortem  examination  reveals  a  suppurative  but 
secondary  inflammation  of  the  mucous  membrane  of  the  nasal 
cavities,  pharynx,  larynx,  and  trachea. 

In  the  bronchi,  sometimes  very  deeply  placed,  remains  of  foreign 
bodies  are  found  in  cases  where  some  solid  material  has  been  inhaled. 
The  mucous  membrane  of  the  bronchi  is  violet  in  colour,  in  places 
appears  to  l)e  sloughing,  and  is  covered  by  gangrenous  patches  immersed 
in  a  reddish-grey  putrid  fluid  of  offensive  odour.  In  places  the  pul- 
monary tissue  has  undergone  gangrene  ;  and  incision  of  the  diseased 
centres  discovers  irregular  cavities,  filled  with  a  pultaceous,  greyish 
material,  which  often  makes  its  way  into  the  l)ronchi.  These  are  the 
irregular  cavities  which  give  rise  to  the  gurgling  sounds.  The  walls  of 
these  cavities  are  formed  of  disintegrating  pulmonary  tissue,  which 
again  is  surrounded  by  a  zone  of  grey  hepatisation.  The  gangrenous 
areas  may  unite,  forming  vast  caverns.  If  near  the  surface  they 
cause  adhesive  or  septic  pleurisy. 

Diagnosis.  The  diagnosis  is  not  very  difficult,  provided  that  an  exact 
account  can  be  obtained  of  the  circumstances  which  preceded  the  appear- 
ance of  the  disease.  The  signs  furnished  by  the  discharge,  the  expired 
air,  percussion  and  auscultation  are  sufficiently  significant  to  remove  any 
doubt. 

Prognosis.  The  prognosis  is  extremely  grave,  and  in  the  great 
majority  of  cases  fatal. 

Treatment.  There  is  very  little  chance  of  recovery,  no  matter  what 
treatment  may  be  employed.  The  most  favourable  termination  consists 
in  the  gangrene  remaining  limited  to  the  bronchi  and  to  a  small  frag- 
ment of  the  lung,  so  that  the  damaged  tissues,  being  gradually  delimited 
and  sloughed  oft",  may  finally  be  discharged  by  coughing. 

This  is  an  exceptional  termination,  but  attempts  may  be  made  to 
assist  its  evolution  by  giving  alcohol  in  doses  of  8  to  10  ounces  per  day, 
and  salicylate  of  soda  in  doses  of  4  to  5  drachms.     When  the  condition 

D.C.  A  A 


354  LUNGS    AND    PLEURA. 

can  be  early  diagnosed  before  intense  and  continued  fever  has  set  in, 
and  ^Yhen  the  animal's  condition  is  good,  it  is  often  preferable  to 
slaughter  the  patient. 

INFECTIOUS    BRONCHO -PNEUMONIA. 

The  ox's  lung  is  lial)le  to  so  many  and  such  extremely  varied 
diseases  that  it  seems  desirable  to  add  to  the  above  descriptions 
some  remarks  on  infectious  broncho-pneumonia  of  external  or  in- 
ternal  origin. 

Anatomically  these  forms  of  broncho-pneumonia  are  characterised 
by  the  occurrence  of  "  islands  "  of  pulmonary  hepatisation,  more  rarely 
by  extensive  (massive)  hepatisation ;  in  all  cases  the  hepatisation  is 
irregular,  and  in  no  way  resembles  that  of  simple  pneumonia. 

Causation.  The  internal  causes  are  numerous  and  varied.  They 
are  due  to  primary  infection  of  an  organ  whence  arises  a  general  infec- 
tion, sometimes  even  true  septicaemia.  Some  form  of  broncho- pneu- 
monia, such  as  simple  broncho-pneumonia,  purulent  broncho-pneu- 
monia, gangrenous  broncho-pneumonia,  etc.,  then  follows  as  a  compli- 
cation. These  l^roncho-pneumonias  are  therefore  only  manifestations 
of  purulent  infection  or  septicaemia.  They  frequently  follow  post- 
partum infections,  vaginitis,  metritis,  and  suppurative  mammitis. 

Symptoms.  The  general  symptoms  first  attract  attention,  and  are 
extremely  acute.  They  comprise  high  fever,  loss  of  appetite,  cessation 
of  rumination  and  of  milk  secretion,  breathlessness,  blowing,  etc. — all 
signs  of  grave  and  rapidly  progressive  infection. 

Sometimes  at  this  period  nothing  more  than  the  primary  lesion,  such 
as  metritis  or  mammitis,  can  be  detected.  It  may  even  happen  that  the 
uterus  seems  little  affected,  and,  despite  the  accelerated  respiration, 
neither  partial  nor  complete  dulness  of  the  lung  is  discovered. 

Hepatisation  only  occurs  some  days  afterwards,  and  with  it  irregular 
partial  dulness  localised  in  the  lower  zones,  disappearance  of  the  respira- 
tory murmur  in  the  corresponding  regions,  exaggeration  in  the  infected 
regions,  an  expiratory  sound  which  is  barely  perceptible  or  may  be  of  a 
blowing  character,  or,  again,  after  several  days  may  be  transformed  into 
a  tubal  souffle. 

The  cough  then  becomes  frequent,  generally  difficult,  paroxysmal, 
feeble,  and  easily  provoked.  The  appetite  suffers,  the  patients  seem 
to  prefer  fluid  nourishment  and  lose  flesh  very  rapidly. 

[f  the  broncho-pneumonia  is  about  to  terminate  in  suppuration 
or  gangrene, "the  respiration  becomes  sighing,  the  breath  foetid,  and 
the  cough  is  accompanied  by  a  greyish  muco-purulent  or  gangrenous 
discharge. 


INFECTIOUS   BRONCHO-PNEUMONIA.  355 

When  the  abscesses  are  deep-seated,  the  alarmmg  symptoms  retam 
their  primary  degree  of  intensity  for  weeks,  until  the  animals  are 
completely  exhausted.  Abscesses,  originating  in  deep-seated  parts, 
may  even  extend  towards  the  surface  of  the  lung,  and  produce  either 
adhesive  pleurisy  that  can  be  detected  by  palpation,  or  exudative 
pleurisy,  easily  recognised  on  percussion. 

When  the  infective  microbes  are  not  pyogenic  the  general  con- 
dition appears  less  grave,  the  animals  exhibit  only  moderate  fever, 
appetite  is  diminished  but  not  lost,  wasting  is  slower,  and  may  con- 
tinue for  months,  but  the  affected  portions  of  lung  become  converted 
into  fibrous  masses  or  a  material  resembling  spleen  pulp. 

The  duration  of  infectious  broncho  -  pneumonia,  therefore,  varies 
with  the  nature  of  the  infecting  organism.  In  cases  which  terminate 
in  gangrene,  the  animals  may  survive  for  three  or  four  weeks ;  in 
those  where  suppuration  occurs,  for  several  months.  In  short,  recovery 
is  the  rule  in  simple  broncho-pneumonia  ;  but  from  an  economic  stand- 
point there  is  little  reason  for  keeping  the  animals  alive. 

Diagnosis.  The  diagnosis  is  not  generally  very  difficult ;  for  if  at  first 
the  case  may  be  mistaken  for  one  of  simple  pneumonia,  the  persistence 
or  prolonged  aggravation  of  the  symptoms  and  the  irregularity  in  posi- 
tion of  the  lesions  revealed  by  percussion  and  auscultation  enable  the 
condition  to  be  distinguished  at  an  early  period  from  simple  pneumonia. 

Confusion  with  acute  or  chronic  pleuro-pneumonia  may  easily  be 
avoided  by  noting  the  absence  of  pleural  effusion,  and  of  the  soft 
pleuritic  souffle  of  peripneumonia,  etc. 

Where  auscultation  is  chiefly  relied  upon  it  is  more  difficult  to 
differentiate  between  this  disease  and  acute  tuberculosis,  and  between 
it  and  broncho-pneumonia  produced  by  foreign  bodies,  although  the 
latter  disease  develops  differently. 

Prognosis.  The  prognosis  is  always  extremely  grave  and,  in  cases 
where  there  is  gangrene  or  abscess  formation,  fatal.  From  the  economic 
standpoint  the  chronic  form  is  also  very  grave. 

Treatment.  As  broncho-pneumonia  is  frequently  of  a  secondary 
character,  treatment  should  at  first  be  particularly  directly  against  the 
primary  condition,  whether  in  the  mammary  gland,  uterus  or  else- 
where. Early  treatment  of  suppurative  mammitis,  metritis,  etc.,  is 
therefore  necessary. 

Broncho-pneumonia  is  treated  by  free  vesication  of  the  walls  of 
the  chest,  the  administration  of  tonics  and  antiseptics,  alcohol  in  small 
doses,  acetate  of  ammonia  in  doses  of  1  to  2  drachms,  salicylate  of 
soda  in  doses  of  5  to  8  drachms  per  day,  salicylic  acid  in  doses  of  1 
drachm,  and  creosote  in  doses  of  1^  to  5  drachms,  given  in  electuary,  etc. 

Diuretics,  farinaceous  gruels,  etc.,  may  be  used  freely,  and  are  of  value. 

A  A    '2 


356  LUNGS    AND    PLEURA.. 

If  the  symptoms  persist  or  ))ecome  aggravated,  and  suggest  the 
development  of  an  abscess  or  gangrene,  it  is  l)etter  to  slaughter  the 
animal. 

BRONCHO-PNEUMONIA    OF    SUCKING    CALVES. 

Young  animals  still  with  the  mother,  particularly  calves  during  the 
first  few  weeks  of  life,  are  liable  to  broncho-pneumonia  of  a  specialised 
character,  as  regards  not  only  its  causes,  but  its  development  and  duration. 

Causation.     The  causes  may  be  grouped  under  two  principal  heads : — 

(a)  In  slow  or  difficult  cases  of  parturition,  the  foetus  may  be  injured 
whilst  being  delivered,  as  a  consequence  of  direct  compression  of  the 
great  blood-vessels,  etc.  (particularly  of  compression  of  the  umbilical 
cord,  compression  of  the  thorax  in  the  cardiac  region,  or  partial  pre- 
mature separation  of  the  enveloiies),  and  may  thus  by  reflex  action 
make  automatic  inspiratory  movements. 

Eespiration  being  impossible,  inasmuch  as  the  thorax  has  not  yet 
passed  the  posterior  passages,  such  inspiratory  efforts  made  during 
the  passage  through  the  pelvis  may  cause  amniotic  liquid  to  pass  into 
the  bronchi.  This  accident  is  particularly  liable  to  occur  during 
deliveries  with  breech  presentation.  If,  as  happens  frequently,  the 
amniotic  liquid  has  become  infected  either  prior  to  or  as  a  conse- 
quence of  obstetrical  manipulation,  the  result  is  fatal ;  for  the  pas- 
sage of  infected  amniotic  fluid  into  the  bronchi  develops  a  broncho- 
pneumonia of  a  degree  of  gravity  depending  on  the  character  of 
infection. 

(h)  By  an  entirely  different  mechanism  broncho-pneumonia  may 
occur  in  sucking  calves  during  the  first  few  weeks  of  life,  even  in  the 
case  of  animals  born  in  a  vigorous  condition,  and  kept  in  warm  and 
well-arranged  stables.  This  form  follows  diarrhoea,  and  constitutes  a 
final  complication  whiclr  is  always  of  very  marked  gravity,  and  in 
most  cases  fatal. 

Such  secondary  l)roncho-pneumonia  only  occurs  when  the  diarrhoea 
has  resisted  treatment,  and  it  is  important  to  note  that  the  pectoral 
lesions  appear  at  a  time  when  the  intestinal  mischief  seems  to  have 
diminished,  the  diarrhoea  having  lessened  or  disappeared.  This  variety 
of  broncho -pneumonia  of  young  animals  is  by  far  the  most  frequent. 
It  has  been  termed  broncho-pneumonia  of  intestinal  origin,  and  exactly 
resembles,  so  far  as  its  development  and  gravity  are  concerned,  the 
broncho-pneumonia  in  young  infants  described  by  Sevestre  and  Lesage. 

The  term  broncho-pneumonia,  moreover,  is  not  strictly  correct,  or 
at  least  is  not  exclusive ;  for  the  rapid  forms  often  exhibit  lesions 
other  than  those  of  broncho-pneumonia.  Post-mortem  examination 
reveals  pleurisy  and  pericarditis. 


BRONCHO-PNEUMONIA    OF   SUCKING   CALVES.  357 

Pathogeny.  At  the  outset  of  these  attacks  of  broncho- puhnonary 
disease,  a  careful  bacteriological  examination  of  the  organisms  to  be 
found  in  the  discharge  of  bronchial  mucus  leads  to  the  discovery  of 
bacilli  which  do  not  stain  with  Gram,  and  which  resemble  varieties 
of  the  colon  bacillus  ;  in  other  cases  of  streptococci.  At  a  later  stage, 
when  the  animal  has  become  weak,  micro-organisms  are  present  in 
much  greater  variety.  Nocard  found  in  lung  abscesses  the  bacillus 
of  epizootic  lymphangitis.  It  seems  that  the  development  of  various 
lesions  in  the  thoracic  cavity  may  be  due  to  auto-infection,  i.e.,  to 
the  penetration  from  the  intestine  of  germs  which,  after  passing 
through  the  circulation,  establish  themselves  at  some  point  in  the 
lung.  The  pleura  is  attacked  at  a  later  period  as  a  consequence  of 
continuity  and  contiguity  of  tissue. 

In  a  similar  way  pericarditis  and  even  valvular  endocarditis  may  be 
l^roduced. 

Symptoms.  The  symptoms  are  similar  to  those  of  all  forms  of 
broncho-pneumonia.  Where  diarrhoea  has  been  neglected,  the  condi- 
tions may  apparently  improve  without  evident  cause,  whilst  the  respi- 
ration becomes  more  frequent.  The  patient  soon  suffers  from  cough, 
and  in  a  few  hours  the  existence  of  broncho-pneumonia  is  clearly 
apparent.  Acceleration  of  breathing  is  the  dominant  symptom.  The 
respirations  may  rise  to  fifty  to  sixty  per  minute,  at  which  they  con- 
tinue, while  fever  sets  in.  On  percussion  the  thorax  may  appear  of 
normal  resonance  throughout;  but  when  pleural  lesions  and  exudates 
exist,  resonance  gives  place  to  partial  or  complete  dulness.  Should 
pericarditis  or  small  cardio-pericardial  adhesions  exist,  they  may  escape 
observation,  but  if  the  exudate  is  abundant  or  the  adhesions  multiple  or 
of  large  size  the  usual  symptoms  of  pericarditis  develop  progressively. 

On  auscultation  the  respiratory  murmur  is  always  found  to  be  greatly 
exaggerated  in  the  healthy  parts,  usually  the  upper  portions  of  the  lung. 
On  the  contrary,  it  is  attenuated  or  suppressed  in  the  afiected  regions. 
The  other  signs  vary  greatly,  according  to  the  extent,  intensity,  and  more 
or  less  advanced  condition  of  the  lesions.  Crepitant  and  bronchial  rales, 
blowing  respiration  and  tubal  souffles,  etc.,  are  among  the  symptoms. 

The  duration  of  the  disease  varies ;  some  patients  may  be  carried  oft' 
in  five  or  six  days,  while  others  survive  for  one  or  two  months,  or  even 
longer.  A  few  recover,  but  they  remain  thin,  puny,  and  atrophied,  and 
are  not  worth  keeping  alive. 

Lesions.  The  lesions  extend  to  the  bronchi,  the  pulmonary  tissue, 
and  sometimes  the  pleura  and  pericardium.  They  consist  in  lesions  of 
difi'use  broncho-pneumonia,  pleurisy  with  false  membranes  and  parieto- 
pulmonary  adherences,  and  pericarditis  with  partial  cardio-pericardial 
adhesions. 


368  LUNGS   AND   PLEURA.. 

In  rare  cases  abscesses  caused  by  p_yogenic  streptococci  may  be 
found. 

The  anterior  lobes,  cardiac  lobes,  and  lower  part  of  the  posterior  lobes 
are  those  singled  out  for  attack. 

Diagnosis.  The  diagnosis  is  not  difficult,  provided  that  the  circum- 
stances preceding  the  appearance  of  the  pulmonary  lesions  are  known. 

Prognosis.     The  prognosis  is  very  grave. 

Treatment.  Treatment  very  often  proves  useless,  because  the  patients 
have  little  resisting  power  and  are  exhausted,  and  also  because  they  are 
suffering  from  a  slowly  progressive  septiesemia.  It  may,  however,  be 
worth  while  in  the  early  stages  to  apply  blisters  to  the  chest  and  ad- 
minister general  stimulants :  alcohol  in  doses  of  8  to  12  drachms  per  day, 
divided  into  two  parts  and  mixed  with  milk  ;  acetate  of  ammonia  in  doses 
of  ^  to  1  ounce  ;  and  tinctura  digitalis  5  to  6  drops. 

The  primary  disease  of  the  intestine  is  masked  by  the  pulmonary 
symptoms,  but  should  not  be  overlooked.  Eice  water,  sub-nitrate  or 
salicylate  of  bismuth  may  be  added  to  the  milk  or  albuminous  solu- 
tions constituting  the  diet.  When  an  epizootic  of  broncho-pneumonia 
complicates  the  diarrhoea  it  is  necessary  to  take  all  the  preventive 
measures  w'hich  have  been  suggested  in  connection  with  white  scour 
and  umbilical  diseases  in  calves.  These  comprise  disinfection  of  the 
premises  and  local  disinfection  of  the  animals  affected. 

SCLERO'CASEOUS    BRONCHO-PNEUMONIA    OF    SHEEP. 

The  sheep  suffers  from  a  special  form  of  broncho-pneumonia,  which 
is  seldom  seen  except  in  isolated  cases,  but  which,  under  exceptional  cir- 
cumstances, may  nevertheless  attack  a  certain  number  of  animals  in  a 
particular  flock.  It  was  first  noticed  and  described  by  Lienaux  in  1896, 
and  has  more  recently  been  studied  by  Sivori  (1899).  Moussu  has  only 
seen  it  in  flocks  in  the  north  of  France. 

Causation.  The  causes  of  this  disease  are  still  imperfectly  under- 
stood. 

Sivori's  researches  show  that  the,  disease  may  be  referred  to  a  micro- 
organism, but  we  do  not  yet  know  exactly  by  what  path  infection  occurs. 

The  agent  of  sclero-caseous  broncho-pneumonia  in  the  sheep  appears 
similar  to  that  described  by  Preisz  and  Guinard  in  1891,  and  identical 
with  the  microbe  of  ulcerative  lymphangitis  of  the  horse  (Nocard,  1897). 
It  is  probable  that  infection  occurs  through  the  respiratory  apparatus. 

Symptoms.  The  clinical  development  of  the  disease  is  difficult  to 
describe,  because  its  course  is  slow  and  unaccompanied  by  well-marked 
external  signs. 

The  animals  lose  flesh,  pant  for  breath  when  moved,  drop  to  the 
rear  of  the  flock    cough  frequently,  feed  badl      and  end  li§'  becoming 


PULMONARY   EMPHYSEMA.  359 

cachectic.  Many  suffer  from  the  disease  and  yet  remain  in  fair  bodily 
condition. 

On  i)ost-mortem  examination  the  hmgs  are  found  not  to  collapse, 
having  lost  their  elasticity,  and  are  of  a  yellowish-white  colour,  which  is 
only  seen  in  this  disease.  On  section  the  pulmonary  tissue  appears 
dense,  hard,  and  of  a  fibrous  and  lardaceous  character.  At  various 
points  nodules  with  fibrous  envelopes  and  caseous,  yellowish  or  greenish 
contents  are  found. 

When  the  caseous  nodules  are  near  the  surface  the  pleura  may  be 
chronically  inflamed  and  thickened.  The  liver  and  kidney  frequently 
contain  caseous  lesions. 

Diagnosis.  The  diagnosis  becomes  easy  after  the  first  post-mortem 
examination,  for  the  lesions  discovered  cannot  be  mistaken  for  those 
of  parasitic  broncho-pneumonia,  degenerated  pulmonary  echinococcosis 
or  tuberculosis.  In  the  living  animal,  on  the  contrary,  the  diagnosis 
is  extremely  difficult. 

Prognosis.  The  prognosis  is  grave.  No  special  method  of  treat- 
ment is  known. 

PULMONARY    EMPHYSEMA. 

Pulmonary  emphysema,  i.e.,  exaggerated  dilatation  of  the  pulmonary 
tissue  by  air,  is  not  uncommon  in  the  bovine  species,  and  occurs  under 
the  two  classical  forms — (1)  alveolar  or  intra-lobular  emphysema  limited 
to  dilatation  of  the  alveoli ;  and  (2)  interlobular  emphysema,  produced 
by  the  entrance  and  diffusion  of  air  in  the  interlobular  spaces  in  con- 
sequence of  rupture  of  the  lobules. 

These  two  forms  are  very  frequently  associated : — 

(1.)  Emphysema  by  dilatation  usually  begins  in  the  right  pretracheal 
lobe ;  also  in  the  cardiac  and  even  in  the  posterior  lobes. 

(2.)  Interlobular  emphysema  begins  in  the  same  regions,  but  it 
spreads  readily  in  a  backward  direction,  remaining  interstitial ;  or,  on 
the  other  hand,  becoming  sub-pleural  at  the  periphery  of  the  lung. 

In  both  cases  the  pulmonary  tissue  is  pale,  the  blood-vessels  are 
partially  obliterated  by  compression  ;  circulation  and  aeration  of  the 
blood  are  impeded— hence  the  appearance  of  the  disturbance  noted. 

Causation.  Emphysema  is  seen  in  adult  working  oxen ;  also,  and  to 
an  even  greater  degree,  in  aged  cows.  It  is  produced  by  excessive  strains 
in  draught,  or  more  often  by  the  paroxysms  of  coughing  so  common 
during  simple  or  parasitic  bronchitis,  broncho-pneumonia,  pneumonia, 
chronic  broncho-pneumonia,  etc.     Successive  gestations  also  produce  it. 

All  these  pathological  conditions  also  interfere  with  the  nutrition  of 
the  bronchial  mucous  membrane,  particularly  of  its  deep-seated  muscular 
layer,  which  is  then  incapable  of  regulating  the  distribution  of  air  ni  the 


360  LUNGS    AND    PLEURAE. 

bronchial  channels.  The  distribution  being  no  longer  regulated  by  reflex 
action,  air  accumulates  at  certain  points  as  a  result  of  the  expiratory 
efforts  made  during  coughing,  and  dilatation  of  the  vesicles  or  lobules 
occurs. 

Diseases  of  the  digestive  apparatus,  acute  or  chronic  tympanites  in 
particular,  may  plaj^  a  certain  part  by  compressing  the  diai^hragm, 
causing  expiratory  efforts  and  fits  of  coughing. 

Furthermore,  swelling  of  the  lymphatic  glands  at  the  entrance  to 
the  chest,  by  compressing  the  pneumo-gastrics,  provokes  reflex  cough 
and  finally  emphysema. 

Symptoms.  Pulmonary  emphysema  is  marked  by  accelerated  re- 
spiration due  to  diminution  in  the  respiratory  cajiacity,  which  is  often 
very  seriously  afi:'ected ;  to  insufficient  absorption  of  oxj^gen  in  con- 
sequence of  diminution  in  the  space  available  for  exchange  of  gases  in 
the  lung,  and  to  insufficiency  of  expiration.  This  acceleration  in  breath- 
ing, though  little  marked  during  repose,  becomes  very  pronounced  after 
exercise,  or  during  hot  weather ;  and  under  these  circumstances  is 
accompanied  by  a  paroxysmal,  feeble  but  shrill  cough,  without  discharge. 
This  cough  without  discharge  is  frequently  followed  by  swallowing. 

Percussion  reveals  an  important  point,  viz.,  increase  in  the  normal 
resonance  of  the  thorax. 

On  auscultation  the  vesicular  murmur  is  found  to  be  diminished,  the 
respiration  assumes  a  rough  and  rasping  character,  inspiration  is  diffi- 
cult, expiration  painful,  and  often  divided  into  two  periods,  as  indicated 
by  a  slight  double  movement  of  the  flank.  Expiration  is  clearly  audible. 
Its  duration  is  generally  less  than  that  of  insjDiration,  although  in  some 
cases  it  is  equal  or  even  longer.  It  is  accompanied  by  sibilant  and 
snoring  rdlcs,  sometimes  even  mucous  rales,  of  an  intermittent  character. 
In  rare  cases  there  may  be  difficulty  of  respiration,  as  in  broken-winded 
horses. 

Diagnosis.  The  diagnosis  may  suggest  a  doubt  as  to  whether 
emphysema  or  tuberculosis  is  present,  but  in  the  latter  there  is  fever, 
the  general  condition  is  poor ;  on  percussion  the  thorax  reveals  areas 
of  partial  dulness ;  and  expiration  is  rough  and  prolonged,  sometimes  of 
a  blowing  character,  a  peculiarity  which  is  exceptional  in  emphj^sema. 

Prognosis.  The  prognosis  is  not  very  grave,  except  where  emphy- 
sema is  only  an  accompanying  symptom  of  another  disease,  such  as 
chronic  bronchitis,  tuberculosis,  etc. 

Treatment.  Little  can  be  done  to  check  the  development  of  the 
above  descriljed  pulmonary  lesions ;  but  the  cough  may  be  relieved,  and 
the  pulmonary  circulation  improved  by  assisting  the  heart. 

The  most  prompt  and  efficacious  assistance  is  given  by  digitalis  in 
doses  of  ^  to  1  drachm  per  day  for  adults,  iodide  of  potassium  in  doses  of 


DISEASES   OF   THE   PLEURA.  301 

1  to  1^  drachms,  and  bromide  of  potassium  in  doses  of  1  drachm  to 
guard  against  reflex  excitabiUty  of  the  pneumo-gastric.  This  treatment, 
however,  should  not  be  followed  for  more  than  five  or  six  days,  and 
should  then  be  replaced  by  the  administration  of  arsenious  acid  in  doses 
of  15  grains  per  day,  ground  horse-chestnuts  in  doses  of  3  ounces  per 
day,  etc.,  etc. 

DISEASES    OF    THE    PLEURA. 

Primary  inflammation  of  the  pleura  is  very  rare  in  animals  of  the 
bovine  species,  but  secondary  diseases  of  this  membrane,  on  the  other 
hand,  are  frequent. 

ACUTE    PLEURISY. 

Cruzel,  Fabry,  and  a  number  of  practitioners  have  described  the 
occurrence  in  working  animals  of  acute  pleurisy  a  frigore  or  sero- 
fibrinous pleurisy  in  consequence  of  severe,  sudden  variations  in  tem- 
perature, or  prolonged  chills.  At  the  present  day  it  seems  fairly  well 
established  that  pneumonia,  and  not  pleurisy,  is  commonest  under  such 
conditions,  and  Moussu  disclaims  ever  having  seen  primary  pleurisy. 
On  the  other  hand,  pleuritic  eff"usions  are  very  common  in  contagious 
pleuro-pneumonia,  secondary  pleurisy  due  to  pericarditis  produced  by 
foreign  bodies,  septic  broncho-pneumonia  or  broncho-pneumonia  due  to 
foreign  bodies,  and  the  pleurisy  which  accompanies  septicaemia  con- 
sequent on  parturition,  etc.  These  forms  of  disease,  however,'  are  not 
simple  sero-fibrinous  pleurisy,  but  septic  or  suppurative  pleurisy,  still 
little  understood  in  veterinary  surgery. 

Tuberculosis  of  the  pleura,  although  very  frequent,  is  rarely  accom- 
panied by  marked  exudation.  Like  secondary  disseminated  pleural 
carcinoma,  it  usually  assumes  the  vegetative  and  adhesive  form,  with 
adhesions  of  greater  or  less  extent  between  the  lung  and  wall  of  the  chest. 

Symptoms.  In  all  these  morbid  conditions  the  symptoms  vary 
greatly,  and  it  would  be  difiicult  to  give  an  accurate  general  descrip- 
tion of  them. 

In  acute  pleurisy  a  frigore  shivering  attacks,  moderate  fever,  dulness, 
loss  of  appetite,  interference  with  rumination,  dryness  of  the  skin,  rapid 
wasting  and  intercostal  pain,  first  indicated  by  dull  colic,  constitute  the 
usual  symptoms. 

The  respiration  is  short  and  irregular,  interrupted  when  the  exuda- 
tion is  abundant.  Pressure  over  the  intercostal  spaces  produces  pain,  as 
does  strong  percussion.  Percussion  reveals  an  area  of  dulness  bounded 
above  by  a  horizontal  line. 

Auscultation  shows  the  respiratory  murmur  to  have  disajjpeared 
throughout  the  zone   of   dulness,  and  reveals   the   presence   of   a   soft 


362  LUNGS   AND   PLEURA. 

pleuritic  souffle  (a  soft  tubal  souffle  quite  different  from  that  of  con- 
tagious i)leuro-pneumonia)  when  pleural  exudation  is  abundant.  In 
septic  or  su^jpurative  pleurisy  fever  is  higher,  loss  of  appetite  more 
marked,  wasting  more  rapid,  and  depression  extreme,  with,  however, 
identical  local  S3'mptoms. 

Diagnosis.  The  diagnosis  of  pleural  exudation  presents  little  diffi- 
culty, because  of  the  peculiar  characters  of  the  dulness  and  the  pathogno- 
monic indications  obtained  by  auscultation.  The  exudation  is  usually 
unilateral,  the  mediastinum  being  very  resistant  and  not  perforated 
in  the  ox. 

By  passing  the  needle  of  a  Pravaz's  syringe  with  antiseptic  pre- 
cautions through  the  intercostal  space  a  little  fluid  may  be  drawn  off 
and  the  diagnosis  formed,  the  form  and  nature  of  the  pleurisy  being 
simultaneously  established.  The  liquid  extracted  can  be  examined  bac- 
teriologically,  and  can  be  grown  on  nutritive  media,  or  inoculated  into 
exi^erimental  animals. 

The  prognosis  is  grave,  because  in  the  ox  pleurisy  is  very  often  of 
a  secondary  character.  The  outlook  varies,  however,  with  the  form  of 
the  pleurisy  and  the  nature  and  virulence  of  the  infecting  organism. 

Treatment.  Treatment  consists  firstly  in  applying  an  energetic 
vesicant  like  antimonial  ointment  or  liquid  cantharides  blister ;  in- 
ternally diuretics  such  as  soda  bicarbonate,  nitrate  of  potash,  resin, 
and  decoctions  of  pellitory,  dogs'  grass,  etc.,  may  be  given.  If  thought 
desirable  the  chest  may  be  tapped  and  the  pleural  cavity  washed  out 
with  an  antiseptic  solution. 

CHRONIC    PLEURISY. 

Chronic  pleurisy  is  frequent  in  aged  animals,  but  usually  assumes  the 
form  of  local  adhesive  pleurisy.  The  adhesions  between  the  lung  and 
pleura  are  more  or  less  extensive ;  they  result  from  verminous  broncho- 
pneumonia, echinococcosis,  external  injuries,  etc.  Clinically  this  form 
is  of  no  importance,  and  is  almost  impossible  to  diagnose.  During 
the  development  of  pleural  tuberculosis,  on  the  contrary,  adhesive  dry 
pleurisy  is  frequent,  and  sometimes  becomes  so  well  marked  that  almost 
the  whole  of  the  opposing  pleural  surfaces  may  become  united. 

PNEUMO'THORAX. 

The  name  pneumo-thorax  is  given  to  the  condition  produced  by  the 
entrance  of  air  or  gas  into  one  of  the  pleural  cavities. 

The  accident  is  usually  produced  by  rupture  of  the  parenchyma  of 
the  lung  and  of  the  pleura,  a  rupture  which  produces  a  communication 
between  the  alveoli  or  a  bronchus  and  the  corresponding  pleural  cavity. 


PNEUMO-THORAX. 


363 


As  soon  as  the  rupture  occurs  air  passes  from  the  lung  into  the  pleural 
cavity,  and  the  lung  collapses  in  consequence  of  the  resilience  of  its 
elastic  constituents. 

Under  other,  much  rarer,  circumstances  pneumo-thorax  occurs  in  con- 
sequence of  gas  generated  in  the  digestive  tract  passing  into  the  pleural 
spaces.  The  condition  then  makes  rapid  progress,  and  death  occurs  in  a 
few  days. 

Symptoms.  The  symptoms  are  well  defined.  As  soon  as  the  acci- 
dent occurs  the  animal  exhibits  extremely  marked  and  sudden  dyspnoea, 
accompanied  by  heaving  at  the  flank  or 
general  agitation  of  all  the  muscles  of 
the  body.  One  of  the  lungs,  in  fact,  has 
suddenly  been  called  on  to  perform  the 
functions  of  both,  and  at  first  it  natu- 
rally has  great  difficulty  in  meeting  this 
demand. 

The  heaving  at  the  flank  and  the 
general  agitation  of  the  body  muscles  is 
due  to  the  fact  that  the  regularity  and 
rhythm  of  contraction  of  the  diaphragm 
are  disturbed,  and  the  mechanical  condi- 
tions have  become  difterent  on  the  two 
sides.  From  the  first,  respiration  is 
moaning  and  expiration  becomes  rapid, 
stertorous  and  deep,  while  the  face  is 
anxious-looking,  and  the  nostrils  are  di- 
lated as  though  the  animal  was  on  the 
point  of  suffocation.  On  examining  the 
animal  from  in  front  or  behind,  the  thorax 
is  easily  seen  to  be  wanting  in  symmetry, 
the  side    on  which   the   pneumo-thorax 

has  occurred  being  immobile  as  compared  with  the  sound  side.  The 
latter,  moreover,  is  dilated  in  order  to  compensate  for  the  loss  of  function 
of  the  collapsed  lung. 

Percussion  reveals  greatly  increased  resonance  on  the  side  of  the 
pneumo-thorax.  On  the  other  hand,  the  opposite  side  yields  a  normal 
sound. 

Auscultation  reveals  an  increase  of  the  respiratory  murmur  on  the 
side  which  is  still  acting  and,  on  the  contrary,  complete  and  total  sup- 
pression of  the  respiratory  murmur  on  the  afiected  side.  On  applying 
the  ear  to  the  chest  wall,  a  large  soft,  amphoric  souffle  of  well-marked 
metallic  character  is  heard.  This  is  particularly  clear  on  respiration, 
giving  the  impression  of  the  existence  of  a  large  cavity  beneath  the  ear. 


Fig.  171. — Schema  illustrating  open 
pneumo-thorax.  Eight  lung  col- 
lapsed; pericardium  and  heart 
displaced  towards  the  right. 


364  LUNGS   AND    PLEURJ-l 

The  sighing  sound  heard  on  auscultation  of  the  chest  wall  is  louder  than 
that  heard  externally  or  over  the  region  of  the  nostrils  or  larynx ;  and  it 
seems  to  he  reinforced,  as  though  hy  the  resonance  of  a  large  cavity  with 
thin  metallic  walls.  Once  or  twice  per  minute,  moreover,  a  sound  may 
be  heard  like  that  of  dropping  water.  It  is  of  a  very  special  character, 
resembling  that  produced  by  drops  falling  to  the  bottom  of  a  hollow 
metallic  vase,  and  setting  up  prolonged  vibration. 

As  secondary  symptoms  the  heart's  action  is  accelerated,  the  number 
of  beats  rising  to  80  or  even  120  or  130  beats  per  minute  ;  appetite  is 
lost ;  slight  tympanites  develops  as  a  result  of  rumination  and  eructa- 
tion being  suspended ;  the  peristaltic  movements  of  the  rumen  are  inter- 
rupted, and  constipation  develops. 

Diagnosis.  The  diagnosis  of  pneumo-thorax  is  easy,  and  the  con- 
dition can  scarcely  be  mistaken  for  any  other  except  diaphragmatic 
hernia ;  but  the  indications  derived  from  percussion  and  auscultation 
are  so  different  in  the  two  cases  that  they  need  not  be  further 
emj^hasised. 

The  task  becomes  more  difficult,  however,  when  an  attempt  is  made 
to  identify  the  exact  form  of  pneumo-thorax,  for  three  principal  varieties 
are  recognised. 

In  open  pneumo-thorax,  the  first  and  most  frequent  form,  air  passes 
from  the  lung  into  the  pleura  at  each  inspiration,  and  flows  back  from 
the  pleural  cavity  towards  the  bronchus  at  each  expiration.  The  intra- 
pleural pressure  is  then  approximately  equal  to  the  intra-bronchial 
pressure,  and  undergoes  similar  oscillations.  (It  should  be  noted  that 
the  aperture  in  the  lung  is  seldom  sufficiently  large  to  establish  an 
absolute  equality  of  pressure  between  the  bronchus  and  the  pleural 
cavity.  Eespiration,  therefore,  though  very  seriously  impeded,  generally 
continues  in  a  modified  form.) 

In  a  second  variety,  termed  "  valvular  pneumo-thorax,"  air  passes 
freely  from  the  lung  into  the  pleural  cavity,  but  is  unable  to  return 
from  that  cavity  towards  the  lung,  because  a  flap  of  tissue  acts  as  a 
valve  and  closes  the  orifice  at  the  commencement  of  expiration.  As 
soon  as  intra-pleural  pressure  rises  above  that  of  the  inspiratory  effort, 
the  valve  remains  permanently  closed. 

In  the  third  variety,  called  "  closed  pneumo-thorax,"  the  oriffce  of 
communication  is  obstructed  by  some  mechanism,  and  the  pleural  sac 
only  contains  a  film  of  air. 

In  practice,  valvular  pneumo-thorax  is  recognised  by  the  movement 
of  the  thoracic  wall  (which  in  open  and  closed  pneumo-thorax  remains 
depressed),  as  well  as  by  extreme  intensity  of  the  dyspnoea  and  attacks  of 
threatened  suffocation.  Closed  pneumo-thorax,  which  is  only  a  termiiui- 
tion   and  a  stage  in  the  cure  of  open  pneumo-thorax  and  of  valvular 


PNEUMO-THORAX.  365 

pneumo-thorax,  is  suggested  by  progressive  improvement  in  the  symp- 
toms. Scientifically  it  is  very  easy  to  make  this  diagnosis  by  putting  a 
manometric  apparatus  in  communication  with  the  pleural  cavity  by  means 
of  a  simple  hollow  needle  provided  with  a  thick-walled  rubber  tube. 

In  open  pneumo-thorax  the  liquid  column  in  the  manometer  under- 
goes rhythmic  oscillations  corresponding  to  the  respiratory  movements ; 
in  valvular  pneumo-thorax  the  intra-pleural  pressure  increases  progres- 
sively until  it  becomes  higher  than  the  external  pressure ;  and  finally, 
in  closed  pneumo-thorax,  the  column  of  the  manometer  assumes  a  cer- 
tain level  at  which  it  rests. 

Prognosis.  The  prognosis  is  very  variable,  according  to  the  primary 
cause  of  the  accident.  Animals  might  recover,  but  economically  there 
is  little  advantage  in  preserving  them  when  the  diagnosis  is  assured, 
except  in  cases  of  animals  of  great  value,  and  when  the  primary  disease 
admits  of  it. 

Causation.  Pneumo-thorax  may  be  produced  by  various  causes. 
The  most  frequent  cause  in  large  animals  is  pulmonary  echinococcosis, 
during  the  course  of  which  a  peripulmonary  vesicle,  after  having  injured 
several  lobules,  one  of  the  air  passages  or  even  a  bronchiole,  may  break 
through  the  pleura,  thereby  setting  up  direct  communication  between 
the  bronchi  and  the  pleural  cavity. 

To  pulmonary  tuberculosis,  with  peripheral  softened  tubercles, 
perforating  simultaneously  into  an  alveolus  or  a  small  bronchus  and 
iiito  the  pleura,  must  be  assigned  the  second  place. 

Vesicular  and  interstitial  sub-pleural  pulmonary  emphysema  is  also 
a  frequent  cause  of  pneumo-thorax,  the  pleura  being  ruptured  over  the 
emphysematous  points. 

Finally,  and  exceptionally,  an  abscess  of  the  lung  may  open  into  the 
pleura  and  form  sinuses,  which  may  establish  a  communication  between 
the  digestive  reservoirs  and  pleural-sacs ;  but  such  accidents  produce 
pyo-pneumo-thorax  and  septic  pleurisy  of  a  rapidly  fatal  character. 

The  diagnosis  of  pneumo-thorax,  and  even  of  its  varieties,  does  not, 
however,  enable  one  to  form  a  prognosis ;  the  important  point  is  to 
ascertain  the  original  cause. 

Treatment.  It  may  be  said  of  pneumo-thorax  that  no  treatment 
exists,  and  that  the  position  is  one  of  expectancy.  In  fact,  we  possess 
no  means  of  directly  dealing  with  such  diseases  as  echinococcosis,  tuber- 
culosis, or  emphysema.  For  this  reason  it  is  best  as  a  rule  to  advise 
slaughter.  Nevertheless,  when  the  condition  is  due  simply  to  pulmonary 
echinococcosis  of  a  discrete  character,  there  is  some  chance  that  after 
several  months  the  animal  may  recover  spontaneously.  The  communi- 
cating orifice  becomes  closed  by  reparative  processes  (cicatricial  contrac- 
tion, the  formation  of  a  false  membrane,  limited  adhesion  between  the 


366 


LUNGS   AND   PLEUR/E. 


two  walls  of  pleura,  etc.)  ;  the  layer  of  air  imprisoned  within  the  pleural 
cavity  is  progressively  absorbed,  provided  that  it  has  not  been  acci- 
dentally infected ;  the  collapsed  and  partially  splenised  lung  progres- 
sively regains  its  function  under  the  inspiratory  efforts,  and  after  some 
months  complete  recovery  may  occur.  This  termination  cannot  always 
be  confidently  predicted,  because  complications  may  arise  at  any  moment ; 
under  no  circumstances  can  complete  recovery  be  anticipated  when  the 
primary  disease  is  tuberculous. 

In  cases  of  valvular  pneumo-thorax  with  extreme  oppression,  attacks 
of  suffocation  threatening  death  as  a  consequence  of  excessive  intra- 
pleural pressure,  displacement  of 
the  mediastinum  towards  the  oppo- 
site side,  compression  of  the  heart, 
and  functional  disturbance  of  the 
sound  lung,  it  may  be  worth  con- 
sidering whether  the  attacks  of 
suffocation  and  threatened  asphyxia 
can  be  modified  or  removed  by  pre- 
venting the  excess  of  intra-pleural 
pressure.  By  simply  passing  a  stout 
hollow  needle  through  one  of  the 
intercostal  spaces,  the  intra-pleural 
pressure  may  be  reduced  to  that  of 
the  external  atmosphere,  and  the 
effects  of  compression  removed. 
This,  however,  is  a  last  resort,  and 
has  no  permanent  effect. 


Fig.  172. — Hydro-pneumo-thorax.  I,  Point 
of  adhesion  of  the  i^leura ;  P,  healthy 
lung ;  Ps,  splenised  lung ;  E,  liquid 
or  purulent  exudate ;  Ca,  air  cavity 
constituting  pneumo-thorax  ;  C,  heart. 


HYDRO-PNEUMO-THORAX    AND 
PYO-PNEUMO-THORAX. 


When  pneumo-thorax  is  set  up, 
it  rarely  remains  simple.  In  the 
great  majority  of  cases  the  pleura 
becomes  infected,  either  directly,  by  the  lesion  which  has  determined 
the  pneumo-thorax  (tubercle,  superficial  abscess,  actinomycotic  lesion, 
etc.),  or  secondarily,  by  the  penetration  of  germs  from  the  air  or  from 
the  bronchus  (echinococcosis,  emphysema).  Simple  pneumo-thorax  then 
becomes  converted  into  hydro-pneumo-thorax  or  pyo-pneumo-thorax, 
according  to  circumstances — that  is  to  say,  whether  the  exudation  into 
the  pleural  cavity  is  of  a  simple  character  or  is  of  the  nature  of  pus. 
Symptoms.  Hydro-pneumo-thorax  is  characterised  by  the  signs 
common  to  true  pneumo-thorax,  which  constitutes  the  primar}'  lesion, 
viz.,  sudden  difticulty  in   breathing,   exaggerated  unilateral  resonance. 


HYDRO-PNEUMO-THORAX    AND    PYO-PNEUMO-THORAX.  867 

amphoric  souffle  accompanied  by  a  sound  like  that  of  drops  of  water 
faUing  into  a  metallic  vessel,  and  by  the  signs  of  secondary  exudative 
pleurisy,  viz.,  moderate  fever,  dulness  over  the  lower  zones  of  the  chest, 
limited  above  by  a  horizontal  line,  slight  splashing  sound,  and  a  soft 
distant  pleuritic  souffle. 

All  the  secondary  symptoms — loss  of  appetite,  suppressed  rumination, 
sighing,  accelerated  pulse,  etc. — are  found  in  a  more  or  less  accentuated 
form. 

In  pyo-pneumo-thorax  fever  is  more  marked,  while  the  signs  noted 
on  auscultation  and  percussion  are  identical,  and  are  accompanied  by 
digestive  disturbance  and  marked  oedema  of  the  wall  of  the  chest, 
which  can  be  seen  or  detected  by  palpation. 

Diagnosis.  The  diagnosis  is  relatively  easy  when  the  lesion  is 
secondary ;  but  the  difficulty  (as  in  simple  pneumo-thorax)  is  to  identify 
the  exact  character  of  the  primary  affection. 

On  the  other  hand,  pyo-pneumo-thorax  and  hydro-pneumo-thorax 
are  not  always  complete ;  adhesions  of  very  varying  character  may  exist 
between  the  lung  and  the  chest  wall ;  hence  it  is  impossible  to  group 
together  all  the  possible  symptoms. 

Diagnosis  is  facilitated  by  aseptically  puncturing  the  chest  with  a 
Pravaz's  syringe. 

Prognosis.  The  prognosis  is  extremely  grave  even  in  cases  of  hydro- 
pneumo-thorax.  Treatment  is  useless,  for  even  allowing  that  the  primary 
disease  might  be  cured,  this  process  of  cure,  after  reabsorption  of  the 
transudate,  would  be  extremely  tedious,  and  the  animals  would  long 
remain  in  poor  condition. 

Treatment.  In  hydro-pneumo-thorax  no  treatment  is  advisable. 
Nothing  is  gained  by  thoracentesis,  at  least  at  an  early  stage,  or  before  the 
lesion  causing  the  pneumo-thorax  has  closed. 

In  pyo-pneumo-thorax,  on  the  contrary,  the  theoretical  course  is  to 
evacuate  the  pus  and  completely  wash  out  the  pleural  sac  with  lukewarm 
non-irritant  solutions  of  antiseptics. 


CHAPTER    V. 

DISEASES    OF    STRUCTURES   ENCLOSED    WITHIN   THE 
MEDIASTINUM. 

The  mediastinum  is  a  space  enclosed  in  the  median  plane  of  the 
thorax  by  the  ajDproach  of  the  two  opposite  layers  of  plem'a.  Needless 
to  say,  at  those  points  where  the  layers  are  in  apposition,  the  space  is 
theoretical  only.  It  extends  from  the  suprasternal  region  to  the  dorsal 
subvertebral  region,  and  encloses  all  the  vessels  which  pass  from  or  to 
the  base  of  the  heart,  the  trachea,  the  oesophagus,  the  pneumo-gastrie, 
diaphragmatic  and  cardiac  nerves,  etc.,  as  well  as  the  pericardial  sac  and 
the  heart.  The  organs  most  frequently  affected  are  the  lymphatic  glands 
lodged  in  the  thickness  of  the  mediastinum,  the  glands  placed  at  the 
entrance  to  the  chest,  the  bronchial  glands,  and  the  glands  situated  in  the 
posterior  mediastinum. 

Inflammation  of  the  mediastinum  may  coincide  with  inflammation  of 
the  mediastinal  layers  of  the  pleura  ;  but  this  can  only  be  detected  on 
post-mortem  examination.  The  lesions  which  can  be  recognised  during 
life  are  simple  inflammation  of  glands,  resulting  from  pulmonary  or 
pleural  diseases,  tuberculous  inflammation  of  glands,  and  the  presence  of 
cancerous  tumours  of  the  mediastinum  and  hypertrophy  of  glands  due 
to  lymphadenitis. 

Simple  inflammation  of  the  lymphatic  glands  is  secondary  and 
consecutive  to  broncho-pneumonia,  verminous  bronchitis,  infectious 
bronchitis,  etc. 

It  produces  reflex  irritation  by  compressing  the  pneumo-gastrie  and 
laryngeal  nerves,  and  is  indicated  by  loud,  spasmodic  coughing. 

Treatment  consists  in  administering  iodide  and  bromide  of  potassium, 
terpine,  in  doses  of  1  drachm  per  day  for  adults,  essence  of  turpentine 
and  tar  water. 

Tuberculous  inflammation  of  glands,  inseparable  from  pulmonary 
tuberculosis,  has  very  special  characteristics  peculiar  to  tuberculosis. 

Inflammation  due  to  lymphadenitis  is  also  very  easy  to  diagnose 
as  a  rule,  in  consequence  of  the  symmetrical  enlargement  of  lymphatic 
glands  elsewhere. 


TUMOURS   OF   THE   MEDIASTINUM.  369 

TUMOURS  OF   THE  MEDIASTINUM. 

Sarcomata,  carcinomata,  lymphomata,  and  lympho-sarcomata  all 
occur  in  the  mediastinum.  They  attack  young  healthy  animals,  and 
sometimes  develop  with  such  rapidity  that  in  a  few  weeks  they  become 
generalised  and  invade  the  heart,  lungs,  and  principal  viscera.  Their 
cause  is  at  yet  unknown. 

Symptoms.  At  first  sight  the  symptoms  are  much  like  those  of 
pericarditis  caused  by  foreign  bodies.  They  consist  in  deformity  of 
the  presternal  region,  swelling  of  the  jugulars,  submaxillary  oedema, 
irregular  pretracheal  tumefaction,  etc. 

The  tumour,  whatever  its  nature,  commences  in  the  mediastinmn, 
develops  towards  the  entrance  to  the  chest,  where  it  projects,  and  before 
long  produces  in  the  pretracheal  region  clearly  marked  oedematous 
swelling. 

Between  the  two  first  ribs  the  tumour  compresses  the  carotids,  the 
jugulars,  the  nerve  trunks,  and  also  the  trachea  and  oesophagus,  pro- 
ducing difficulty  in  the  return  circulation,  especially  in  the  jugulars, 
swelling  in  the  submaxillary  space,  loss  of  appetite  and  dyspnoea. 

Palpation  aft'ords  indication  of  a  tumour  of  soft  consistence,  bosse- 
lated,  more  or  less  adherent  to  the  skin,  usually  painless  on  pressure, 
and  of  irregular  development.  Compression  of  the  oesophagus  inter- 
feres with  the  deglutition  of  rough  forage,  impedes  rumination,  prevents 
eructation,  and  thus  produces  trifling  but  permanent  tympanites. 

The  heart  is  aflected  reflexly  or  directly  as  a  result  of  generalisation 
of  the  tumour,  and  the  pulse  may  rise  to  70  or  even  120  per  minute. 

During  the  first  stages  neither  auscultation  nor  percussion  points  to 
any  pulmonary  lesion.  At  a  later  stage  the  lung  itself  may  be  affected. 
The  other  important  functions  are  normal. 

Animals  suffering  from  sarcoma,  carcinoma,  or  lympho-sarcoma  of 
the  mediastinum  waste  very  rapidly,  lose  appetite,  become  feverish,  and 
soon  develop  cachexia. 

Diagnosis.  The  diagnosis  of  tumour  of  the  mediastinum  is  easy, 
because  of  the  well-marked  character  of  the  apparent  symptoms. 

Prognosis.  The  prognosis  must  be  regarded  as  extremely  grave, 
and  in  most  cases  fatal,  for  there  is  no  active  method  of  intervention, 
extirpation  being  impossible. 

There  is  no  treatment.     The  animal  should  at  once  be  slaughtered. 


D.C. 


SECTION    IV. 

THE    ORGANS    OF    CIRCULATION. 

SEMIOLOGY    OF    THE    ORGANS    OF    CIRCULATION. 

The  semiology  of  the  circulatory  a^jparatus  comprises  the  clinical 
examination  of  the  heart,  arteries  and  veins,  and  the  examination  of  the 
pulse  and  blood. 

Heart.  In  animals  of  the  bovine  species,  the  heart  is  situated  in  the 
thoracic  cavity  opposite  the  third,  fourth,  fifth  and  sixth  ribs,  nearly  in 
the  median  plane  of  the  thorax,  and  inclined  from  front  to  back  at  an 
angle  of  70  degrees. 

The  pericardial  sac  touches  the  extremity  of  the  sternum  where  it  is 
in  immediate  contact  with  the  lower  insertion  of  the  diaphragm.  This 
peculiar  arrangement  favours  the  development  of  pericarditis  due  to 
foreign  bodies. 

On  the  left  side  the  pericardial  sac  may  come  in  direct  contact  with 
the  internal  surface  of  the  thoracic  cavity  opposite  the  lower  extremity  of 
the  third,  fourth,  and  sometimes  fifth  ribs.  At  all  other  points  the 
pulmonary  lobes,  as  expanded  during  inspiration,  separate  it  from  the 
thoracic  wall. 

Although  the  pericardium  and  heart  are  situated  in  the  median  plane, 
percussion  and  auscultation  should  be  performed  on  the  left  side,  since 
the  anterior  and  cardiac  lobes  of  the  left  lung  are  less  developed  than 
those  of  the  right ;  but  the  heart  can  be  auscultated  on  the  right  side,  as 
is  advisable  at  times. 

In  the  healthy  ox  there  exists  an  area  of  the  left  thoracic  wall  which 
may  be  called  the  cardiac  zone,  on  a  level  with  which  are  heard  the 
normal  heart  sounds.  In  diseased  conditions  this  zone  or  area  may 
vary  in  size,  and  the   sounds  may  be  modified. 

The  heart  can  be  examined  by  inspection,  palpation,  percussion, 
and  auscultation. 

Under  ordinary  conditions  inspection  reveals  nothing  in  well-nourished 
animals ;  but  in  very  thin  subjects  and  in  those  suffering  from  recent 
cardiac  lesions  or  pseudo-pericarditis,  a  rhythmic  movement  of  the  chest 
wall  is  sometimes  detected. 


SEMIOLOGY   OF   THE   ORGANS   OF   CIRCULATION. 


371 


Palpation  is  performed  by  placing  the  open  hand  on  the  cardiac  zone. 
In  this  way  the  cardiac  shock  can  be  felt,  its  degree  of  intensity  judged, 
and,  in  an  imperfect  manner,  its  rhythm. 

Percussion  by  means  of  the  fingers  or  a  pleximeter  discloses  the 
extent  of  the  physiological  area  of  partial  dulness,  due  to  the  presence  of 
the  heart,  as  well  as  its  variations  in  pathological  conditions,  particularly 
in  pericarditis  with  marked  exudation. 

In  such  cases  there  may  even  be  complete  dulness  when  the  distended 
pericardium  thrusts  upwards  the  corresponding  pulmonary  lobe,  and  comes 
in  contact  with  the  internal 
surface  of  the  thoracic  wall,  or, 
in  cases  of  pericardial  pneu- 
matosis, exaggerated  resonance, 
and  a  tympanitic  sound. 

Auscultation  is  carried  out 
either  directly  or  by  the  stetho- 
scope or  the  phonendoscope. 
The  normal  or  pathological 
sounds  of  the  heart  are  thus 
ascertained,  as  well  as  the  in- 
tensity of  the  cardiac  beats  and 
sounds,  the  frequency  of  the 
rhythm,  etc. 

When  injuries  have  oc- 
curred which  cause  murmurs, 
it  is  best  to  use  the  stethoscope 
and  to  apply  it  at  the  points 
where  murmurs  are  heard  at 
their  maximum  intensity,  i.e., 
exactly  at  the  spot  where  the  car- 
diac shock  is  noted,  and  towards 
the  base,  in  the  region  where 
the  great  arterial  trunks  begin. 

In  the  latter  case  it  is  often  useful  to  draw  the  left  fore  leg  forward. 

Arteries.  The  arteries  are  rarely  the  seat  of  lesions  that  can  be 
detected  by  examination,  and  therefore  such  examination  is  usually 
limited  to  noting  the  state  of  the  pulse. 

Arteritis  and  thrombosis  of  arteries  are  rare,  and  although  lesions 
of  atheroma  have  been  discovered  in  certain  chronic  diseases,  such  as 
tuberculosis,  chronic  diarrhoea,  etc.,  they  are  difficult  to  detect,  even 
on  examination  per  rectum  of  the  bifurcation  of  the  aorta. 

Pulse.  The  examination  of  the  pulse,  on  the  contrary,  is  of  great 
importance.     In  animals  of  the  bovine  species  the  pulse  may  be  taken  at 

B  B   2 


Fig.  173. — Schema  of  a  section  through  the 
chest  opposite  the  heart.  P^,  Left  lung  ; 
Vd,  right  lung;  cp,  right  and  left  pleural 
cavities  ;  P,  pericardium  ;  I,  V-,  cardiac  lobes 
of  the  lung  interposed  between  the  peri- 
cardium and  thoracic  wall. 


372  THE   ORGANS   OF   CIRCULATION. 

a  number  of  different  points,  such  as  the  submaxillary  artery,  on  the 
side  of  the  lower  jaw :  in  the  case  of  very  thin  animals  at  the  radial 
within  and  in  front  of  the  elbow  joint ;  at  the  internal  saphenous 
artery,  at  the  height  of  the  mamma  or  scrotum ;  or  at  the  coccygeal 
artery,  at   the  base  of  the  tail. 

This  examination  reveals  the  frequency  (50  to  60  per  minute),  the 
quality,  whether  strong,  feeble,  imperceptible,  etc.,  the  regularity, 
etc.,  etc. 

Yeins.  The  veins  are  more  easily  examined  than  the  arteries,  on 
account  of  their  superficial  position  in  most  cases. 

Inspection  and  palpation  are  the  only  means  of  examination. 

Inspection  shows  the  degree  of  fulness  or  collapse,  and  also  the 
existence  or  absence  of  what  has  been  termed  venous  pulse. 

Venous  pulse  occurs  only  at  the  lower  extremity  of  the  jugulars. 
It  is  very  frequent  in  animals  of  the  bovine  species,  and  in  thin  animals 
is  not  necessarily  a  pathological  symptom.  It  is  due  to  reflux  of  blood 
in  the  anterior  vena  cava,  under  the  influence  of  the  expiratory  effort ; 
sometimes  to  emphysema,  tuberculosis,  etc. ;  in  other  cases  to  the 
return  of  blood  towards  the  vena  cava  and  jugulars  at  the  moment  of 
auricular  systole,  as  a  result  of  lesions  of  the  tricuspid  or  auriculo- 
ventricular  orifices. 

By  palpation  of  the  veins  their  permeabilit}'  can  be  estimated,  also 
the  degree  of  distension  or  obstruction,  and  the  condition  of  their 
contents. 

Capillary  system.  Among  methods  of  arriving  at  the  state  of  the 
circulatory  system  must  be  included  an  examination  of  the  vascular  con- 
dition of  the  accessible  mucous  membranes,  such  as  those  of  the  eye, 
mouth,  nostril,  vulva,  etc.  This  examination  is  easy  to  carry  out, 
and  is  of  value  in  diagnosing  congestive  states,  pneumonia,  and  local 
inflammation. 

Blood.  Examination  of  the  blood  is  sometimes  necessary  for  the 
exact  diagnosis  of  certain  diseases,  and  therefore  should  be  carried  out 
whenever  occasion  requires.  The  physical  state,  coloration,  and  rapidity 
of  coagulation  afford  valuable  data  in  certain  diseased  conditions,  and 
indicate  the  approximate  richness  in  hsemoglobin,  the  normal  or  ab- 
normal composition  of  the  plasma,  and  the  richness  of  the  blood  in 
white  corpuscles. 

Microscopic  examination  is  still  more  valuable,  whether  carried  out 
by  the  moist  method,  in  which  a  drop  of  blood  is  compressed  under  a 
cover  glass,  or  the  dry  method  with  or  without  staining.  In  the  latter 
case  the  specimen  is  fixed  with  a  mixture  of  equal  parts  of  alcohol  and 
ether  or  by  immersing  it  in  a  1  per  cent,  solution  of  osmic  acid. 

By  this  means  it  is  possible  to  detect  the  condition  of  the  red  and 


SEMIOLOGY   OF   THE   ORGANS   OF   CIRCULATION.  373 

white  blood  corpuscles  and  haematoblasts  ;  the  existence  or  non-existence 
of  leucocytosis  and  its  degree,  as  well  as  the  existence,  for  instance,  of 
leiicocythfemia. 

The  blood  corpuscles  may  also  be  counted. 

Histological  examination,  supplemented  by  suitable  staining,  reveals 
the  presence  of  normal  or  abnormal  blood  corpuscles,  parasites  such  as 
piroplasma,  or  microbes  such  as  bacteria. 

Such  examination  necessarily  presupposes  a  knowledge  of  what 
should  be  looked  for  in  the  normal  state. 

In  normal  blood  the  red  blood  corpuscles  predominate.  They  are  all 
similar  in  form  and,  with  few  exceptions,  of  the  same  size.  They  stain 
strongly  with  acid  solutions  such  as  eosine.  In  pathological  conditions, 
large  or  giant  corpuscles  may  be  found  (macrocytes),  as  well  as  those  of 
medium  size  (normal)  and  small  size  (microcytes).  Some  are  vigorous 
and  stain  deeply;  others,  on  the  contrary,  are  degenerating  or  dead,  and 
have  no  greater  affinity  for  one  constituent  than  for  another  of  the 
double  or  triple  stains  commonly  employed. 

In  pathological  conditions  the  hsematoblasts  occur  in  very  varying 
numbers. 

The  white  blood  corpuscles  found  in  health  may  be  classified  as 
follows : — 

Large  and  small  lymphocytes,  each  of  which  has  a  round  volu- 
minous nucleus  and  a  narrow  border,  and  contains  a  non-granular 
protoplasm ;  their  proportion  varies  between  22  per  cent,  and  25  per 
cent.  : 

Polynuclear  leucocytes  or  polymorphous  leucocytes  with  a  single 
nucleus,  which  originate  in  bone  marrow,  stain  best  with  neutral  colours, 
and  are  present  in  the  proportion  of  70  per  cent,  to  72  per  cent.  : 

Mononuclear  leucocytes  with  an  ovoid  eccentric  nucleus  stain  best 
with  basic  colours,  and  form  about  1  per  cent. : 

Polynuclear  leucocytes  stain  best  with  eosine  or  acid  colours,  and 
form  about  1  per  cent,  to  2  per  cent. 

When  these  white  blood  corpuscles  are  in  larger  number  the  con- 
dition is  known  as  leucocytosis,  and  when  one  or  other  variety  is  in 
very  great  excess  the  condition  is  known  as  leucfemia. 


CHAPTER    I. 
CARDIAC    ANOMALIES. 

ECTOPIA    OF    THE    HEART. 

Ectopia  of  the  heart,  i.e.,  congenital  malformation  in  which  the  heart 
is  displaced  from  its  normal  position  and  thrust  sometimes  completely 
beyond  the  thoracic  cavity,  is  not  very  rare.  The  heart  may  be  well 
developed,  but  it  is  not  enclosed  by  the  thoracic  walls  when  the  thoracic 
cavity  closes  during  the  first  stages  of  embryonic  life.  The  sternum, 
which  is  cartilaginous  and  becomes  ossified  only  at  a  later  period, 
remains  fissured  along  the  median  line,  and  the  fissure,  usually  of 
oval  form  and  with  rounded  margins,  surrounds  the  auricles  and  the 
vessels  at  the  base  of  the  heart.  The  ventricles  form  a  hernia  pro- 
jecting beyond  the  thorax,  which  then  only  contains  the  two  pleural 
sacs  and  a  complete  mediastinal  partition.  The  pericardium  remains 
undeveloped. 

Despite  this  malformation,  the  embryo  develops.  The  foetus  may 
in  due  season  be  brought  forth  living,  but  as  a  rule  death  occurs  in 
a  few  hours. 

The  diagnosis  is  easy,  but  this  malformation  cannot  be  treated. 
All  that  can  be  done  is  to  protect  the  ectopiated  organ  against  ex- 
ternal violence  in  cases  where  the  young  creature  is  born  alive. 


CHAPTER    II. 
PERICARDITIS. 

Pericarditis  consists  in  inflammation  of  the  pericardial  sac.  It  is 
attributable  to  different  causes,  varying  in  importance  and  in  causation. 

Specific  pericarditis  may  be  produced  by  the  tubercle  bacillus,  or  it 
may  develop  during  an  attack  of  contagious  peripneumonia.  Tuber- 
culous or  peripneumonic  forms  of  pericarditis  as  a  rule  form  only  com- 
plications of  chronic  pulmonary  tuberculosis  or  peripneumonia.  They 
are  very  rarely  primary  in  character,  and,  like  the  allied  forms  of 
pleurisy,  assume  a  vegetative  and  adhesive  form  in  tuberculous  cases. 

Moussu  has  never  seen  the  true  exudative  form  either  in  acute  or 
chronic  tuberculosis,  but  only  vegetative  and  caseous  forms. 

Simple  acute  pericarditis.  Cases  of  simple  acute  exudative  peri- 
carditis have  been  described,  and  have  been  referred  to  chills,  wounds, 
or  injuries  in  the  region  of  the  heart,  and  in  a  few  cases  to  the 
rheumatic  diathesis. 

Such  forms  of  pericarditis  may  occur,  but  probably  are  very  rare, 
for  Moussu  has  seen  but  two  cases.  As  the  symptoms  correspond 
exactly  to  those  of  exudative  pericarditis  produced  by  a  foreign  body, 
it  is  unnecessary  to  describe  them  specially. 

The  only  important  detail  to  bear  in  mind  w'ith  this  disease  is  the 
possibility  of  cure  by  suitable  treatment,  such  as  the  application  of 
stimulants  or  vesicants  to  the  cardiac  zone,  the  administration  of  sali- 
cylate of  soda  or  diuretics,  and  complete  rest. 

The  diagnosis,  moreover,  should  be  confirmed  by  making  an  aseptic 
exploratory  puncture  with  the  capillary  trocar.  The  nature  of  the 
liquid  withdrawn  will  indicate  whether  the  case  is  one  of  simple  acute 
pericarditis  or  pericarditis  due  to  a  foreign  body. 

Cancerous  pericarditis  is  generally  secondary,  and  is  caused  by 
development  of  tumours  on  the  pericardial  serou§  membrane,  and  in 
the  myocardium.  Moussu,  however,  has  seen  one  case  of  primary 
cancerous  pericarditis,  the  tumours  being  found  only  on  the  periphery 
■  of  the  myocardium.  The  growth  assumes  a  vegetative  form  with 
moderate  exudation.  The  symj)toms,  however,  so  closely  approach  to 
those   of   exudative   pericarditis   due   to   foreign   bodies   that   only  the 


376 


PERICARDITIS. 


latter  variety,   which  is  by  far  the  most  frequent  in   animals  of  the 
bovine  species,  need  be  described. 

EXUDATIVE    PERICARDITIS    DUE    TO    FOREIGN    BODIES. 
This  condition  has  been  erroneously  described   as   traumatic   peri- 
carditis,  but  the  latter  term   "svould  suggest  that  the  disease  was  due 
to  an  injury  acting  from  without.     It  may  be  defined  as  a  disease  pro- 
duced by  the  discharge  into  the  peri- 
cardial cavity  of  some  foreign  body 
from  the  gastric  compartments. 

Boizy  in  1858  described  several 
cases  of  this  kind  of  pericarditis. 
Hamon  in  1866  gave  an  excellent 
table  of  symptoms.  Roy  in  1875 
supplemented  this  with  numerous  ob- 
servations showing  clearly  the  pos- 
sibility of  recognising  the  disease  by 
clinical  examination.  Pericarditis  due 
to  foreign  bodies  is  to-day  one  of  the 
best  characterised  diseases  of  the  ox, 
and  it  is  easy  to  diagnose. 

Before  approaching  the  etiological 
side  of  the  question,  it  is  necessary  to 
recall  in  a  few  words  the  anatomical 
arrangement  of  the  pericardium  and 
its  relations  to  neighbouring  organs. 

In  the  ox  the  diaphragm  pre- 
sents a  marked  concavity  directed  to- 
wards the  abdomen.  The  pericardium, 
situated  exactly  in  the  median  plane,  is  fixed  by  its  point  to  the  sternum. 
A  fold  of  adipose  tissue  directly  connects  it  with  the  anterior  surface  of 
the  diaphragm.  On  the  abdominal  side  the  conical  right  compartment 
of  the  rumen  is  in  free  communication  with  the  reticulum,  which  is 
closely  applied  to  the  posterior  surface  of  the  diaphragm  on  the  median 
hne  opposite  the  spot  occupied  by  the  pericardium  on  the  anterior  sur- 
face (Fig.  176).  As  a  result  of  this  arrangement  any  object  passing 
through  the  reticulum  and  diaphragm  in  the  median  plane  would  enter 
the  pericardial  cavity.  These  particulars  indicate  clearly  how  this  form 
of  pericarditis  is  produced. 

Causation.  One  of  the  chief  causes  of  pericarditis  by  a  foreign  body 
is  connected  with  the  way  in  which  oxen  feed.  They  rapidly  swallow  their 
food  and  any  foreign  bodies  that  may  be  concealed  in  it,  submitting 
it  later  on  to  a  second  mastication  in  the  course  of  rumination.     This 


Fig.  174. — Tumours  of  the  surface  of 
the  heart.  Primary  cancerous  peri- 
carditis and  myocarditis. 


EXUDATIVE   PERICARDITIS    DUE   TO   FOREIGN    BODIES.  877 

method  of  feeding  results  in  bolting  the  food  almost  without  mastication, 
hence  the  possibility  of  swallowing  foreign  bodies. 

The  proximity  of  the  reticulum  to  the  pericardium  is  also  an  impor- 
tant factor,  because  the  foreign  bodies  fall  into  the  reticulum  as  soon 
as  the  bolus  of  food  begins  to  break  up.  It  is  important  to  notice, 
moreover,  that  pericarditis  is  commonest  on  farms  where  the  oxen  are 
attended  by  women,  or  in  regions  where  sharp  objects  are  to  be  found  on 
roads  or  pastures  frequented  by  the  animals,  such  as  the  vicinity  of 
needle,  nail,  and  rivet  factories. 

The  sole  cause  is  the  penetration  of  a  foreign  body  into  the  peri- 
cardial sac. 

Pathogeny.  All  kinds  of  foreign  bodies  are  swallowed  by  oxen,  as 
is  abundantly  shown  by  post-mortem  examinations.  These  indigestible 
bodies  pass  with  the  food  into  the  rumen,  and  accumulate  in  the  deepest 
portions  of  that  receptacle.  Owing  to  physiological  contractions  the 
loAver  wall  of  the  rumen  rises  to  the  level  of  the  orifice  of  communication 
with  the  reticulum,  and  so  passes  much  of  the  material  accumulated 
within  it  into  this  organ. 

Soft  foreign  bodies  fall  towards  the  lower  parts  of  the  reticulum,  but 
sharp  objects  may  lodge  in  its  walls.  Very  often  the  bodies  penetrate  in 
this  way  without  causing  reticulitis  or  grave  inflammation.  The  func- 
tions of  the  reticulum  are  not  impeded.  The  commonest  of  such  objects 
are  needles,  pins,  nails,  or  fragments  of  iron  wire.  On  account  of  their 
form,  needles  are  the  most  dangerous.  The  sharpness  of  one  extremity 
ensures  its  passing  readily  through  the  tissues,  and  as  the  point  is 
the  part  that  offers  least  resistance,  the  needle  continues  gradually  to 
penetrate. 

If  the  foreign  body  becomes  imi^lanted  vertically  in  the  lower  wall  of 
the  rumen  or  reticulum  it  may  be  expelled  directly  through  the  medium 
of  an  abscess.  This  is  a  favourable  termination,  though  it  usually 
results  in  permanent  gastric  fistula. 

More  often  the  objects  penetrate  the  anterior  wall  of  the  reticulum 
and  gradually  work  their  way  towards  the  diaphragm,  impelled  by  the 
movements  of  the  reticulum  and  the  other  digestive  compartments. 
They  perforate  the  muscle  and  pass  into  the  thoracic  cavity,  either  in 
the  direction  of  the  pericardium  or  of  the  pleural  sacs. 

First  as  to  the  penetration  of  the  pericardium.  The  foreign  body, 
whatever  it  may  be,  produces  by  its  presence  alone  very  marked  irrita- 
tion, and  as  in  addition  it  is  always  infected  in  consequence  of  its  having 
passed  through  the  digestive  compartments,  inflammation  is  set  up  to  a 
degree  proportionate  to  the  pathogenic  qualities  of  the  infective  agent. 

Symptoms.  The  early  symptoms  are  those  of  indigestion,  and  not  of 
pericardial  disease,  a  fact  which  is  easy  to  understand,  because  at  first  the 


378  PERICARDITIS. 

whole  mischief  is  in  the  abdominal  cavity.  The  patients  are  dull,  rest- 
less, and  seem  to  be  suffering  from  an  obscure  ailment.  They  remain 
standing  more  than  usual,  show  more  than  ordinary  deliberation  in 
lying  down,  lose  appetite,  cease  to  ruminate  regularly,  and  exhibit 
intermittent  tympanites. 

The  cause  of  these  symptoms  is  as  follows  :  At  first  the  reticulum  is 
partly  immobilised  by  the  local  inflammation,  and  at  a  later  stage  move- 
ment of  the  diaphragm  is  checked  by  reflex  action  when  the  sharp  body 
has  progressed  far  enough  to  touch  it.  The  rhythmic  movements  of  the 
reticulum  and  the  diaphragm  are  interfered  with,  rumination  is  dis- 
turbed, eructation  ceases,  and  tympanites  appears. 

The  patient  often  utters  slight  groans,  particularly  when  forced  to 
move ;  l)ut  as  this  is  a  sign  common  to  all  grave  diseases  it  can  only 
give  rise  to  a  suspicion  as  to  what  has  occurred.  In  ten  to  fifteen  days 
this  primary  phase  may  have  terminated ;  but  it  is  impossil)le  to  say 
how  long  it  lasts,  for  it  varies  with  each  animal  as  with  each  variety 
of  foreign  body,  and  it  may  be  prolonged  for  months. 

From  the  moment  it  reaches  the  thoracic  cavity  the  foreign  object 
makes  its  way  towards  the  channel  formed  on  either  side  by  the  ribs  and 
below  by  the  sternum,  and  therefore  towards  the  point  of  the  heart. 
This  is  the  second  phase  of  development. 

The  passage  of  the  foreign  body  through  the  diaphragm  occupies  a 
more  or  less  considerable  time,  depending  on  its  length ;  the  beginning 
of  this  second  phase  is  characterised  by  relative  immobility  of  the  circle 
of  the  hypochondrium  during  respiration.  The  abnormal  sensibility  and 
pain  impede  contraction  of  the  diaphragm. 

Palpation  of  the  region  of  the  xiphoid  cartilage  then  reveals  abnormal 
sensibility,  and  sometimes  causes  the  animal  to  resent  being  handled. 

From  this  time  the  pericardial  symptoms  proper  commence,  the 
foreign  body  having  come  in  contact  with  the  pericardium.  This  phase, 
unlike  those  which  precede  it,  presents  well-defined  symptoms.  The 
irritation  of  the  heart  and  its  ganglionic  system  by  a  foreign  body  in  the 
pericardium  is  shown  by  considerable  acceleration  of  the  heart  beats 
even  before  there  is  any  exudation  into  the  pericardial  sac.  Instead  of 
60  to  70  beats,  the  normal  number,  the  pulse  may  rise  to  80,  90,  100,  or 
even  110  beats  per  minute.  The  heart  sounds  are  tumultuous,  dull  and 
ill-defined,  while  the  pulse  appears  bounding  and  strong. 

But  this  period  of  cardiac  excitement  while  persisting  is  soon  com- 
plicated by  other  symptoms.  As  soon  as  the  foreign  body  penetrates  the 
pericardial  sac,  there  is  infection,  which  produces  an  active  form  of 
inflammation  and  abundant  exudation.  From  this  time  the  pulse  be- 
comes weaker  and  weaker,  until,  under  the  steadily  increasing  pressure 
on  the  heart,  it  is  almost  imperceptible. 


EXUDATIVE   PERICARDITIS   DUE   TO    FOREIGN   BODIES.  379 

There  is  only  moderate  fever.  As  soon  as  the  exudation  becomes 
considerable,  the  symptoms  of  pericarditis  grow  very  marked :  they  may 
be  grouped  in  the  following  order,  according  to  their  importance. 

A.  Cardiac  symptoms.  On  palpation  of  the  cardiac  zone  on  the  left 
the  impulse  of  the  heart  is  no  longer  felt.  Percussion,  which  under 
normal  circumstances  reveals  only  partial  dulness,  now  seems  to  give 
pain,  and  indicates  abnormal  dulness  distributed  in  a  vertical  plane. 
The  pulmonary  lobes  between  the  pericardium  and  thoracic  walls  are 
thrust  upwards.  The  distended  pericardial  sac  approaches  the  parietal 
layer  of  the  pleura  and  may  adhere  to  it,  hence  the  dulness.  This  dul- 
ness extends  as  far  back  as  the  xiphoid  appendix  of  the  sternum,  and  can 
be  detected  on  both  sides,  marginated  above  by  a  convex  line. 

In  rare  cases  the  dulness  is  absent,  being  partially  rej^laced  by  tym- 
panitic resonance,  due  to  the  presence  of  gases  in  the  distended  peri- 
cardial cavity,  which  gases  originate  in  the  digestive  reservoirs  or  result 
from  putrid  fermentation  of  the  pericardial  exudate. 

Simple  or  double  pleurisy,  or  even  pneumonia  of  the  cardiac  lobes 
resulting  from  infection  by  contiguity,  may  complicate  cases  of  rapid 
pericarditis.  The  dulness  then  api^ears  modified,  as  do  the  signs  ob- 
served on  auscultation. 

Auscultation  furnishes  valuable  indications.  From  the  outset  it  re- 
veals acceleration  of  the  heart.  At  a  later  stage,  but  only  for  a  short 
time,  it  permits  of  the  detection  of  the  pericardial  rubbing  sound  which 
precedes  serous  exudation,  and  which  may  persist  for  several  days  when 
large  quantities  of  false  membrane  are  produced. 

If  exudate  is  present  in  considerable  quantities  a  liquid  sound  is 
heard  at  each  heart  beat.  The  heart  appears  to  be  beating  in  water,  but 
the  liquid  note  varies  considerably.  It  has  been  termed  the  "  claclaque  " 
sound  (Lecouturier,  1846),  in  allusion  to  the  sound  produced  by  the 
meeting  of  water  ripples  ;  '•  clapotement "  sound  (Boizy,  1858),  with 
reference  to  the  sound  produced  under  the  influence  of  a  light  breeze 
on  the  borders  of  a  stream;  "  glouglou  "  sound  (Roy,  1875),  suggested 
l\y  the  noise  of  liquid  escaping  from  an  inverted  bottle  into  a  resonant 
vessel,  etc.  It  is  important,  however,  to  remember  that  cases  occur 
(principally  when  the  pericardium  is  greatly  distended  and  entirely  filled 
with  liquid)  where,  with  the  animal  at  rest,  these  sounds  are  difficult  to 
detect.  To  render  them  noticeable  the  patient  must  be  walked  for  a  few 
yards. 

A^ernant,  again,  has  described  a  sound  as  of  dripping  water,  of  quite 
special  character ;  he  compared  it  to  that  resulting  from  the  fall  of  drops 
of  liquid  on  to  a  marble  table  or  into  a  half-filled  vessel.  So  far  as  can 
be  ascertained  this  sound  of  dripping  water  greatly  resembles  that  heard 
in  pneumo-thorax,  but  it  is  less  resonant  and  less  prolonged. 


380 


PERICARDITIS. 


It  appears  to  be  characteristic  of  the  presence  of  air  in  the  peri- 
cardial cavity,  and  its  special  quality  varies  with  the  quantity  accumu- 
lated in  the  pericardium.  Masked  by  these  pericardial  sounds  the 
beating  of  the  heart  seems  dull,  badly  defined,  distant  and  stifled. 

B.  Jugular  symptoms.  The  "jugular"  symptoms  are  secondary, 
and  result  from  the  accumulation  of  liquid  in  the  pericardial  cavity. 
No  intra-pericardial  exudate  can  exist  without  exerting  pressure  on  the 
heart,  and  as  the  auricles  have  very  thin  walls  and  are  more  compres- 
sible than  the  ventricles,  this  pressure  immediately  causes  difficult}^  in 
the  return  circulation,  whence  venous  stasis,  varying  in  intensity,  but 

clearly  visible  and  appre- 
ciable on  account  of  the 
distension  of  the  jugulars. 
The  venous  stasis  is 
general,  for  the  pulmonary 
veins  are  as  much  com- 
pressed as  the  posterior 
and  anterior  venae  cavse, 
but  it  is  only  apparent  in 
the  large  superficial  veins. 
This  stasis  is  accompanied 
by  venous  pulse,  and  par- 
ticularly by  peripheral  or 
internal  oedema,  oedema  of 
the  lung,  intestine,  mesen- 
tery, etc.,  of  the  submaxil- 
lary space  and  of  the  dewlap 
and  entrance  to  the  chest, 
ffidema  of  the  submaxillary 
space  is  specially  charac- 
teristic, for  it  appears  almost 
first  amongst  external  signs.  That  of  the  dewlap  follows  at  a  later  stage, 
and  extends  backwards  as  far  as  the  umbilicus,  rising  above  this  point  as 
high  even  as  the  entrance  to  the  chest  and  the  axillary  region. 

C.  Pulmonary  symptoms.  The  pulmonary  symptoms  result  from 
difficulty  in  the  return  circulation  and  from  the  venous  stasis.  They  are 
due  to  passive  congestion  and  oedema  of  the  lung  or  to  hydro-thorax.  At 
rest  the  respiration  may  appear  fairly  regular,  but  at  the  least  movement 
it  is  accelerated,  and  may  rise  to  40  or  even  60  per  minute. 

Percussion  reveals  lessened  resonance  of  the  parts,  and  in  the  case  of 
hydro-thorax  dulness  marginated  by  a  horizontal  line,  as  in  pleurisy. 

On  auscultation  the  vesicular  murmur  may  sometimes  have  dimi- 
nished or  even  disappeared,  while  the  respiration  may  be  blowing,  as  in 


Fig.  175. — Appearance  of  a  patient  suffering  from 
fully-developed  pericarditis. 


EXUDATIVE   PERICARDITIS   DUE   TO    FOREIGN   BODIES.  381 

active  congestion,  and  in  exceptional  cases  a  tubal  souffle  may  be 
observed.  In  most  cases  the  animal  has  a  paroxysmal,  somewhat  fre- 
quent cough,  due  to  reflex  irritability  of  the  pneumo-gastric. 

Cruzel  in  addition  mentions  a  double  respiratory  movement  like  that 
produced  in  the  horse  by  broken  wind.  This  is  really  the  result  of 
hydro-thorax,  and  is  not  a  constant  symptom. 

D.  General  symptoms.  When  the  disease  has  lasted  a  certain 
time  the  patients  show  certain  well-marked  general  symptoms :  they 
remain  standing  in  one  position  for  long  periods,  with  the  head  and 
neck  extended,  the  front  legs  thrust  outwards  from  the  trunk  and  the 
body  rigid,  as  though  the  least  movement  caused  them  pain.  The 
general  attitude  expresses  anxiety,  the  animals  lie  down  with  great  care 
and  seldom  remain  long  in  this  position,  which  interferes  with  the 
functions  of  the  heart  and  lung.  In  the  last  stages  the  animals 
remain  constantly  standing,  appetite  is  almost  entirely  lost,  and  they 
waste  rapidly. 

The  course  of  pericarditis  due  to  foreign  bodies  is  very  variable. 
Sometimes  death  occurs  in  eight  or  ten  days.  In  other  cases  the  animal 
may  survive  for  weeks,  provided  it  is  well  tended.  Everything  depends 
on  the  rapidity  with  which  the  foreign  body  moves  and  on  the  character 
of  the  infectious  organisms  which  it  introduces  into  the  pericardium. 
Death  is  the  inevitable  termination,  and  occurs  as  a  consequence  of 
cardiac  and  respiratory  syncope.  It  may  follow  suddenly  as  the  result 
of  a  simple  forced  movement,  even  when  the  animal  still  seems  to  retain 
some  amount  of  strength.  When  the  organisms  introduced  into  the  peri- 
cardium are  of  marked  virulence,  complications  such  as  septic  pleurisy 
and  pneumonia  may  be  observed,  and  death  soon  takes  place. 

It  has  been  suggested  that  recovery  might  follow  a  return  of  the 
foreign  body  towards  the  reticulum.  This  view  can  only  have  been 
advanced  as  a  consequence  of  errors  in  diagnosis,  either  as  to  the  exist- 
ence of  pericarditis  or  as  to  its  nature.  Pericarditis  due  to  cold  or  rheu- 
matism sometimes  becomes  cured  spontaneously. 

Death,  again,  may  suddenly  occur  by  syncope  when  the  foreign  body 
penetrates  the  myocardium,  passes  through  it,  and  enters  the  ventricular 
cavities. 

The  return  of  the  foreign  body  is  not  conceivable,  at  all  events  after 
it  arrives  in  the  pericardial  cavity.  Up  to  that  time  the  only  dis- 
turbance is  of  a  digestive  character  ;  no  pericarditis  exists.  But  when 
for  example  the  disturbance  is  due  to  long  fragments  of  iron  wire  which 
may  extend  from  the  reticulum  as  far  as  the  pericardium,  it  is  clear  that 
the  pericarditis  is  of  a  kind  which  cannot  be  cured  without  leaving 
traces.     In  our  opinion,  natural  recovery  is  impossible. 

Diagnosis.     The  diagnosis  of  pericarditis  cannot  be  made  until  such 


382  PERICARDITIS. 

pericarditis  actually  exists,  i.e.,  until  the  disease  has  arrived  at  the  third 
stage  of  development  mentioned  above. 

As  long  as  the  symptoms  point  only  to  the  first  or  second  stage,  the 
logical  diagnosis  is  reticulitis  produced  by  a  foreign  body.  At  this  time 
the  development  of  pericarditis,  although  possible,  is  not  inevitable. 

When,  on  the  other  hand,  one  knows  how  the  digestive  disturbance 
has  originated  and  developed  and  thereafter  notes  signs  of  cardiac  irrita- 
tion, disappearance  of  the  cardiac  impulse,  dulness  of  the  heart  sounds, 
venous  stasis,  etc.,  the  diagnosis  is  easy  even  thus  early. 

Mistakes  are  not  very  likely.  Only  in  some  cases  are  they  liable  to 
occur,  as  in  acute  peripneumonia  of  the  anterior  pulmonary  lobes, 
causing  compression  of  the  pericardium  of  the  anterior  vena  cava  and 
producing  secondarily  venous  stasis  and  oedema  of  the  dewlap.  Cases 
of  specific  pericarditis  due  to  peripneumonia  also  occur,  and  under  such 
circumstances  a  mistake  would  be  even  more  excusable.  Nevertheless, 
the  temperature  curve  in  itself  is  a  sure  indication,  for  whilst  in  peri- 
pneumonia the  fever  is  always  very  marked,  it  is  scarcely  noticeal)le  in 
pericarditis  due  to  a  foreign  body. 

When  the  diagnosis  of  pericarditis  has  been  arrived  at  it  is  desirable 
to  determine  the  exact  nature  of  the  disease,  for  whilst  cases  of  peri- 
carditis due  to  foreign  bodies  are  incurable  and  in  the  interest  of  the 
owner  the  animals  should  be  slaughtered,  pericarditis  due  to  cold  or 
rheumatism  may  be  successfully  treated.  Kheumatism  generally  affects 
the  synovial  membranes  even  before  it  produces  pericarditis,  and  this 
indication,  supplemented  by  the  history  of  the  case  usually  ensures  one 
against  mistakes  regarding  the  initial  cause. 

It  is  much  more  difficult  to  distinguish  pericarditis  due  to  a 
foreign  body  from  pericarditis  due  to  carcinoma  and  from  the  forms 
of  pseudo-pericarditis  produced  by  lesions  in  the  neiglibourhood  of  the 
heart.  When  considering  the  latter  we  shall  deal  with  this  particular 
point. 

Prognosis.     The  prognosis  is  always  fatal. 

Lesions.  When  the  foreign  body  is  very  thin  and  sharp,  the  reti- 
culum may  not  become  attached  to  the  diaphragm.  In  such  cases  its 
passage  has  been  rapid  and  the  tissues  have  healed. 

Usually  the  reticulum,  diaphragm  and  pericardium  are  united  by  a 
mass  of  fibrous  tissue  as  thick  as  a  man's  arm.  It  resembles  a  fibrous 
sleeve  surrounded  by  an  oedematus  zone,  usually  of  slight  extent.  This 
mass  of  new  fibrous  tissue  is  traversed  l)y  a  sinuous  tract  resulting  from 
the  irritant  action  of  the  foreign  body  on  the  surrounding  tissues.  All 
writers  describe  this  fibrous  sleeve,  which,  however,  only  occurs  in  cases 
where  a  very  long  foreign  body  has  occupied  a  considerable  time  in  pass- 
ing from  the  reticulum  to  the  cavity  of  the  chest. 


EXUDATIVE    PERICARDITIS    DUE    TO    FOREIGN    BODIES. 


383 


In  very  exceptional  cases  the  sinuous  tract  is  ramified,  possibly  as  a 
result  of  displacements  of  the  foreign  body. 

The  orifices  of  the  tract  are  to  be  found,  one  in  the  reticulum,  the 
other  in  the  pericardium.     On  the  side  of  the  reticulum  there  is  never  |^ 
more  than  one  opening,  and  in  many  instances  the  tract  is  already  closed 
on  that  side,  either  by  exuberant  granulations  or  by  a  cicatrix. 

On  the  contrary,  the  fistula  is  more  frequently  open  in  the  pericardial 
cavity.     Its  walls  are  of  very  varying  appearance,  depending  on  their  age  : 


Fig.  176.— Appearance  of  the  lesions  in  a  case  of  fatal  pericarditis.  P,  inflamed  peri- 
cardium, distended  with  exudate  and  adherent  to  the  neighbouring  pulmonary  lobes  ; 
],  posterior  lobe  ;  2,  cardiac  lobe  ;  3,  anterior  lobe ;  Fp,  pleural  false  membranes. 


they  may  be  red,  greyish,  soft  or  hard,  and  when  the  lesion  is  of  old 
standing  they  may  have  been  converted  into  a  sclerotic  tissue. 

The  pericardium  appears  distended  with  a  considerable  quantity  of 
liquid  of  a  special  character — sometimes  sero-sanguinolent,  sometimes 
almost  or  entirely  purulent ;  sometimes  yellowish,  or  greenish-grey ; 
sometimes  frothy,  inodorous,  or  very  foetid. 

These  characters  depend  on  the  nature  and  number  of  the  germs 
which  have  invaded  the  pericardial  cavity.  They  also  vary  with  the 
gravity  and  number  of  the  hemorrhages  produced  by  the  action  of  the 
foreign  body  on  the  myocardium. 


384  PERICARDITIS. 

The  quantity  of  liquid  also  varies  within  very  wide  limits.  There 
may  be  scarcely  any  exudation.  In  that  case  the  pericarditis  is  of  a 
partially  adhesive  character,  with  abundant  false  membranes.  As  a 
rule  the  quantity  of  fluid  exudation  varies  between  seven  and  eight 
quarts,  but  sometimes  the  quantity  is  much  greater.  Trasbot  de- 
scribed an  instance  in  which  the  united  weights  of  the  heart  and  peri- 
cardium exceeded  36  lbs.  Hamon  mentioned  a  case  of  pericarditis  in 
which  the  liquid  exudate  exceeded  twenty  quarts. 

When  inflammation  is  first  set  up  the  liquid  is  serous,  yellowish, 
or  reddish-yellow.  It  contains  fibrinous  Hocculi  in  suspension.  Little 
by  little  this  exudate  becomes  purulent,  whilst  the  internal  layers  of  the 
pericardial  serous  membrane  undergo  desquamation.  These  are  next 
covered  with  false  membranes  of  varying  appearance  ;  the  iibro-albu- 
minous  exudation  is  wrinkled,  villous  and  tufted.  The  two  layers  of 
serous  membrane  are  connected  at  certain  points  by  this  exudation,  the 
adhesions  being  sometimes  very  extensive.  The  pericardial  sac  pro- 
perly so  called  becomes  the  seat  of  marked  lardaceous  thickening,  due 
to  inflammation.  The  heart  appears  entirely  covered  with  a  layer  of 
greyish  or  earthy-coloured  granulation  tissue,  which  appears  as  though 
baked,  and  was  compared  by  Hamon  to  the  back  of  a  toad.  It  is  atro- 
phied as  a  consequence  of  prolonged  compression. 

Under  the  influence  of  the  excentric  pressure  of  the  liquid  the  peri- 
cardial sac  is  distended  and  comes  in  contact  with  the  walls  of  the  chest, 
to  which  it  may  adhere.  The  foreign  body,  especially  if  small,  is  not 
always  easy  to  find. 

The  myocardium  often  displays  interesting  lesions.  At  first  there  is 
thickening,  or  more  commonly  sclerous  degeneration,  of  the  superflcial 
layers  covering  the  ventricles,  and  then  appears  a  crop  of  little  miliary 
abscesses.  Abscesses  of  considerable  size  have  several  times  been 
detected  in  the  walls  of  the  ventricles  and  in  the  interventricular 
septum. 

The  foreign  body,  moreover,  may  not  only  injure  the  myocardium, 
but  may  even  perforate  it  completely  and  produce  ulcerative  endocarditis 
(Cadeac).  In  this  case  infectious  germs  very  rapidly  invade  the  circu- 
lation and  all  the  tissues,  and  the  animal  dies  of  pyaemia. 

These  essential  lesions  are  accompanied  by  others  of  varying  im- 
portance. Thus  the  lung  is  congested  throughout,  and  by  contiguity 
of  tissue  inflammation  may  extend  from  the  pericardium  to  the  lower 
part  of  the  pulmonary  lobes  and  to  the  pleura. 

Interference  with  the  return  circulation  induces  lesions  due  to  venous 
stasis :  dropsy  of  the  chief  serous  membranes,  oedema  of  the  connective 
tissue,  pleural  and  peritoneal  exudations,  etc.  If  the  hind  limbs  never 
become  swollen  it  is  because  the  skin  covering  them  is  very  resistant 


EXUDATIVE   PERICARDITIS   DUE   TO    FOREIGN   BODIES.  385 

and  does  not  readily  yield.  The  liver  becomes  hypertrophied,  congested 
and  engorged  with  blood,  and  when  the  animals  live  for  some  weeks, 
shows  the  appearances  known  as  cardiac  or  nutmeg  liver. 

Treatment.  The  treatment  of  pericarditis  due  to  the  presence  of 
foreign  bodies  is  at  present  merely  palliative.  Often  the  only  thing 
to  be  done  is  to  slaughter  the  animal. 

We  need  not  go  back  to  the  methods  formerly  recommended.  All 
are  illusory  or  mischievous,  such  as  the  use  of  purgatives  to  arrest  or 
reverse  the  progress  of  the  foreign  body,  removal  of  the  foreign  body 
after  opening  the  rumen,  puncture  of  the  pericardium,  etc. 

In  1878  Bastin  successfully  opened  the  pericardium  and  extracted 
the  foreign  body  through  a  window  produced  in  the  thoracic  wall. 

This  operator  recommends  that  after  drawing  the  left  limb  forward 
and  incising  the  skin  and  muscles,  the  operator,  with  his  hand  bound 
round  with  a  cloth,  should  perforate  the  pleura,  and  then  having  found 
the  foreign  body,  proceed  to  extract  it.  By  this  method  it  seems  difficult 
to  cause  perforation  of  the  pericardium,  which  would  certainly  lead  to 
the  production  of  pneumo-thorax  complicated  with  fatal  septic  pleurisy. 

It  must  be  borne  in  mind  that  the  two  pleural  sacs,  right  and  left, 
descend  as  far  as  the  sternum  (Fig.  173),  and  that  it  is  not  possible  to 
touch  the  pericardium  directly  without  perforating  the  pleura. 

Moussu  has  drained  the  pericardium  through  the  pleura  in  the  hope 
of  relieving  the  pressure  on  the  heart  and  facilitating  the  reabsorption  of 
the  oedema,  in  order  to  permit  of  the  subsequent  slaughter  of  the  animal, 
but  has  had  unsatisfactory  results.  Lastly,  he  has  practised  median 
trepanation  of  the  sternum  in  the  infra-pericardiac  region.  Here  again 
the  operation  is  difficult,  because  of  the  (Edematous  infiltration  of  all  the 
substernal  region,  while  it  is  so  dangerous  to  the  patient,  which  must  be 
cast  and  may  suddenly  succumb,  that  it  is  of  no  use  in  ordinary  practice. 

There  is  probably  only  one  condition  in  which  it  would  be  possible  to 
attempt  intervention  with  a  fair  chance  of  success,  that  is,  when  there 
exists  a  fibrous  connection  between  the  pericardium,  lung,  and  wall  of 
the  chest  on  the  right  or  left  side. 

In  such  cases  aspiratory  puncture  or  incision  of  the  pericardium  in 
an  intercostal  space  might  prove  of  service,  because  it  would  not  expose 
the  animal  to  the  danger  of  pneumo-thorax. 

The  only  difficulty  lies  in  ascertaining  beyond  all  question  the  existence 
of  such  an  adhesion  before  attempting  operation,  and  this  is  really  very 
great,  even  having  regard  to  the  form  of  the  dulness  and  the  absence  of 
all  respiratory  sound  in  the  lower  third  of  the  thoracic  cavity  and  cardiac 
zone.  The  pulmonary  lobe  between  the  heart  and  chest  wall  may  be 
thrust  upwards  and  l)e  partially  adherent  to  the  pericardium  and  to  the 
parietal  pleura,  and  at  the  same  time  it  may  be  impossible  to  avoid 
D.c. •  c  c 


386 


PERICARDITIS. 


producing  operative  pneumo-thorax  when  the  cartihiges  are  resected  to 
admit  of  incising  the  pericardium. 

The  only  logical  method  seems  to  be  puncture  of  the  pericardium 
through  the  xiphoid  cartilage,  as  described  below. 

The  topographical  anatomy  of  the  thoracic  viscera  shows  that  the 
point  of  the  pericardium  extends  along  the  sternum  to  a  point  close  to 
the  lower  insertion  of    the  diaphragm,  and  that  the  pericardial  sac  is 


^iH^L. 


r.    Ax.  F. 


Fig.  177.— Lesions  of  exudative  iDeriearditis  produced  by  a  foreign  body.  Relation 
of  tbe  j)ericardium  to  the  sternum  and  ensiform  cartilage.  Pericardium  opened. 
D,  diaphragm  ;  ffi,  oedema  of  the  dewlap,  Ax,  ensiform  cartilage  ;  F,  liver  ;  \b,  gall 
bladder  ;  1,  posterior  lobe  of  the  lung,  drawn  backwards  ;  2,  cardiac  lobe  ;  3,  anterior 
lobe  ;  E,  spot  where  the  foreign  body  penetrated,  towards  the  point  of  the  peri- 
cardium, between  the  neck  of  the  ensiform  cartilage  and  the  circle  of  the  hypo- 
chondrium. 


only  separated  from  the  xiphoid  region,  or  rather  from  the  region  of  the 
neck  of  the  xiphoid  appendix  of  the  sternum,  by  the  fatty  cushion  at  the 
point  of  the  heart. 

A  glance  at  the  annexed  diagram  (Fig.  177)  will  show  this. 

The  diagram,  carefully  reproduced  from  an  anatomical  preparation  of 
an  animal  which  succumbed  to  pericarditis,  shows  that  the  distended 
pericardium  extends  close  to  the  neck  of  the  xiphoid  cartilage. 

First  stage.     Identify  the  three  following  anatomical  guiding  points : — 

(1.)  Xiphoid  appendix  and  white  line.     (2.)  Point  at  which  the  circle  of 


EXUDATIVE   PERICARDITIS   DUE   TO    FOREIGN   BODIES. 


387 


the  hypochondrium  becomes  attached  to  the  sternum.  (3.)  Point  at  which 
the  external  mammary  vein  penetrates  the  abdominal  wall  (Fig.  178). 

Lines  uniting  these  three  points  enclose  a  right-angled  triangle,  which 
the  operator  must  imagine  to  be  bisected  by  a  third  line. 

The  incision,  which  should  be  about  8  inches  in  length,  follows  this 
bisecting  line  at  an  equal  distance  between  the  white  line  and  the  circle 
of  the  hypochondrium,  to  a  point  within  about  8  inches  of  the  anterior 
margin  of  the  mamma.  All  these  points  are  readily  observable  before 
the  animal  is  cast. 

The  cutaneous  incision  affords  exit  to  large  quantities  of  fluid,  and  the 


VM.a. 


Fig.  178. — Seat  of  operation  for  puncturing  the  pericardium  by  way  of  the  ensiforni 
cartilage.  L  B,  White  line;  H,  hne  of  the  hypochondrium;  V.  M.a.,  anterior 
mammary  vein  ;  P,  point  where  the  pericardium  is  punctured  through  the  incision. 


pectoral  muscles  attached  to  the  neck  of  the  ensiforni  cartilage  can  then 
be  divided  with  the  bistoury.     The  area  of  operation  is  thus  uncovered. 

Second  stage.  The  second  phase  comprises  incision  of  the  tissues 
opposite  the  neck  of  the  ensiform  cartilage,  about  8  inches  in  front  of 
the  base  of  the  triangle  and  at  equal  distances  from  the  points  Nos.  1 
and  2;  incision  through  the  skin  for  a  distance  of  8  inches,  and  dis- 
section of  the  muscles  of  the  ensiform  region  exposed  at  the  neck  of  the 
cartilage. 

By  means  of  the  index  finger  or  the  index  and  middle  lingers  of  the 
right  hand  the  mediastinal  space  is  explored,  and  the  fatty  masses  round 
the  base  of  the  heart  broken  through.  If  the  pericardium  is  greatly 
distended,  the  point  of  the  sac  can  be  felt  with  the  tip  of  the  finger,  or 
its  position  can  be  recognised,  even  from  a  little  distance,  on  account  of 
the  fluid  contents  transmitting  the  impulse  of  the  heart.  The  sensation 
conveyed  to  the  finger  is  very  clear. 

cc  2 


388 


PERICARDITIS. 


The  right  index  finger  is  then  rephiced  hy  the  left,  and,  a  trocar  about 
10  inches  long  and  ^  inch  in  diameter  being  introduced  along  the  index 
finger  used  as  a  director,  the  ^pericardial  sac  is  reached.  The  exudative 
fluid  transmits  the  impulse  due  to  the  beating  of  the  heart,  and  the 
pulsations  can  be  clearl}-  distinguished  when  grasping  the  handle  of 
the  trocar. 

Third  stage.  Digital  exploration  of  the  course  of  the  puncture  and 
fatty  cushion  at  the  base  of  the  heart,  with  the  object  of  discovering  the 
position  of  the  pericardium. 

Fourth  stage.  Puncture  with  a  trocar  about  10  to  12  inches  in 
length,  puncture  of  the  pericardium,  -irrigation  and  dressing. 

The  trocar  is  inclined  in  a  slightly  oblique  direction  from  without 


Fig.  179. — Photograph  of  a  patient  immediately  after  operation.     Extensive 
tedema  of  tlie  dewlap  and  neck. 


inwards  and  forwards  towards  the  median  plane,  in  order  that  the  point 
may  not  deviate  towards  the  left  pleural  sac  ;  the  left  index  finger  is  then 
withdrawn,  and  by  a  sharp  thrust  of  the  right  hand  the  trocar  is  pushed 
forward  about  1  to  1^  inches  and  the  pericardial  sac  is  entered. 

The  position  of  the  canula  should  not  be  altered  whilst  liquid  is 
escaping,  for  if  it  is  thrust  in  too  far  a  considerable  quantity  of  fluid 
may  remain  in  the  deepest  portion  of  the  sac. 

The  cavity  having  been  drained,  a  long  strip  of  iodoform  gauze  is  intro- 
duced into  the  track  and  a  protective  surgical  dressing  applied  over  the 
incision  in  order  to  prevent  infection  by  the  litter. 

In  consequence  of  the  introduction  of  the  fingers  into  the  track  caused 
by  puncture  and  the  escape  of  ^pericardial  liquid  along  the  canula  or  after 
removal  of  the  canula,  the  operative  wound  is  necessarily  infected  ;  but  this 


CttROKlC   PERICARDITIS. 


389 


is  of  little  importance,  because  the  opening  is  inclined  downwards, 
and    also    because   it   is   impossible   to   hope   for   aseptic   healing. 

The  dressing  is  renewed  after  forty-eight  hours,  and  every  three  or 
four  days  afterwards. 

The  cedematous  infiltration  about  the  front  portion  of  the  body 
disappears  rapidly  in  two  to  three  days,  and  should  the  animal  be 
slaughtered  the  meat  is  quite  sound  in  appearance. 

This  operation  does  not  aim  at  effecting  a  cure,  but  is  simply  for  the 
purpose  of  allowing  animals  which  would  otherwise  be  valueless  to  be 
slaughtered  and  sold. 

CHRONIC    PERICARDITIS. 

Pericarditis  when  due  to  tuberculosis  may  assume  the  chronic  form. 
Tuberculous  pericarditis,  at  least  in  a  large  number  of  cases,  is  only  accom- 


FiG.  ISO. — Photograph  of  the  same  subject  as  Fig.  179,  taken  six  claj's  later. 

panied  by  slight  exudation,  which  might  remain  unnoticed  unless  the 
animals  were  carefully  examined;  but  it  causes  the  internal  surface  of  the 
pericardial  sac  and  the  surface  of  the  myocardium  to  become  covered 
with  exuberant  vascular  growths,  which  by  setting  up  adhesions  lead  to 
partial  or  generalised  union  of  the  heart  and  pericardial  sac.  Between 
these  adhesions,  which  form  partitions,  are  found  little  cavities  filled 
with  sero-sanguinolent,  grumous,  or  caseous  liquid.  In  time  the  ad- 
hesions increase  in  number,  pericarditis  obliterates  the  free  space,  and 
the  heart  becomes  wholly  adherent  to  the  pericardium. 

As  in  acute  pericarditis,  the  fibrous  layer  undergoes  thickening  and 
hardening  processes.  The  superficial  layers  of  the  myocardium  undergo 
sclerous  transformation,  and  the  tissues  forming  the  adhesions  them- 
selves may  assume  the  characters  of  fibrous  tissue. 


390 


fERICARDlTlR. 


In  one  solitary  case  Moussu  saw  another  form  of  chronic  pericarditis 
with  complete  adhesion  of  the  heart  and  pericardial  sac,  without  any 
exudation  and  almost  without  any  false  membranes.  He  was  unable  to 
determine  the  exact  cause,  but  was  strongly  inclined  to  regard  the  disease 
as  having  followed  pericarditis  a  frigore  or  pericarditis  of  a  rheumatic 
character. 

Adhesions  l)etween  the  heart  and  pericardial  sac  are  also  said  to  be 
the    inevitable   though    delayed   result    of   all    punctures    of   tlie    peri- 
cardium through  the  ensiform  carti- 
lage in  cases  of  pericarditis  due  to 
a  foreign  body. 

Symptoms.  If  the  chronic  peri- 
carditis is  limited  to  a  few  partial 
adhesions,  it  remains  unnoticed  5 
but  when  it  is  more  marked  it  offers 
certain  signs  of  acute  pericarditis, 
such  as  partial  dulness  of  the  car- 
diac area,  which  is  more  extensive 
than  usual,  disappearance  of  the 
cardiac  shock,  weakening  of  the 
sounds,  feebleness  of  the  pulse, 
very  marked  venous  pulse,  moderate 
stasis,  extremely  rapid  and  aggra- 
vated dyspnoea  when  the  animal  is 
forced  to  walk,  threatened  asphyxia 
if  exercise  is  prolonged,  and  com- 
plete asystole. 

All  these  symptoms  are  due  to 
the  existence  of  adhesions  between 
the  heart  and  pericardium,  which, 
by  destroying  the  interpericardial 
space,  interfere  with  diastole  while 
preventing  regular  systole. 
Sudden  death  is  a  frequent  consequence. 

The  diagnosis  of  chronic  pericarditis  is  very  difficult.  The  prognosis 
is  extremely  grave,  and  we  do  not  possess  any  means  of  dealing  with  the 
condition. 

PSEUDO-PERICARDITIS. 

Under  this  title  we  purpose  grouping  a  certain  number  of  pathological 
accidents  due  to  different  causes,  but  manifesting  themselves  by  identical 
symptoms,  which  symptoms  offer  so  marked  a  resemblance  to  those  of 
pericarditis  produced  by  foreign  bodies  as  to  suggest  the  presence  of  that 


Fig.  181.  —  Schema  of  a  subpleural 
abscess  on  the  right  side  which  pro- 
duced symptoms  of  pericarditis  (pseudo- 
pericarditis) .  Po,  Right  lung,  partly 
splenised  and  thrust  upwards ;  VI, 
parietal  pleura  separated  from  the  wall 
of  the  lower  half  of  the  chest ;  A,  cavity 
of  the  subpleural  abscess. 


PSEUDO-PERICARDITIS.  391 

disease.  This  refers  to  accidents  by  which  the  foreign  body  closely 
approaches,  without  actually  touching,  the  pericardium,  the  lung  or  the 
pleural  sacs,  but  in  which  it  causes  purulent  collections  which  displace 
the  pericardium,  indirectly  compress  the  heart,  and  finally  cause  symp- 
toms of  an  apparently  pericardial  character. 

Causation.  During  the  development  of  pericarditis  the  foreign  body 
perforates  the  reticulum  and  diaphragm,  passing  along  the  middle  line 
of  the  body,  without  which  it  would  not  come  in  contact  with  the  peri- 
cardium. If  the  perforation,  however,  occurs  to  the  right  or  left  of  the 
median  plane,  the  foreign  body  moves  forward  just  as  easily,  but  it 
misses  the  pericardium  and  passes  either  into  the  lung,  where  it  causes 
fatal  pneumonia  ;  or  the  pleura,  where  either  it  sets  up  septic  pleurisy 
in  the  subpleural  connective  tissue  or  produces  an  abscess. 

The  abscess  is  generally  lateral,  situated  in  the  right  subpleural 
region,  or  it  may  develop  below  the  pericardium.  These  are  the  two 
varieties  of  pseudo-pericarditis  seen  by  Moussu. 

There  is,  however,  a  third  variety,  which  might  be  called  "  parasitic 
pseudo-pericarditis."  It  is  extremely  rare,  and  Moussu  has  only  seen 
one  case.  It  was  due  to  the  presence  of  an  enormous  hydatid  cyst  of  the 
right  lung  as  large  as  a  man's  head,  which  was  situated  towards  the 
mediastinal  plane  of  the  lung  and  pressed  on  the  supero-posterior  sur- 
face of  the  heart  and  pericardium.  In  consequence  of  the  permanent 
downward  pressure  which  it  exercised  it  interfered  seriously  with  the 
heart's  action  and  caused  symptoms  of  pseudo-pericarditis. 

Symptoms.  The  general  and  external  symptoms  are  those  of  peri- 
carditis— viz.,  dulness,  diminution  in  appetite,  irregular  rumination, 
wasting,  oedema  of  the  dewlap,  distension  of  the  jugulars,  marked 
venous  pulse,  great  anxiety  and  dyspnoea  when  the  patients  are  forced 
to  move,  etc. 

But  the  cardiac  symptoms  differ  notably,  and  moreover  vary,  accord- 
ing to  the  nature  of  the  lesions.  Speaking  generally  percussion  reveals 
complete  dulness  on  one  or  both  sides,  and  auscultation  always  indicates 
the  absence  of  sounds  due  to  extravasated  fluid  in  the  pericardial  sac. 

When  the  abscess  is  situated  below  the  pericardium,  a  condition 
difficult  to  diagnose,  the  dulness  seldom  extends  very  high  on  either 
side  of  the  chest,  and  the  sounds  heard  over  the  cardiac  area,  while 
much  weaker  than  usual,  are  audible  above  the  normal  points. 

An  abscess  developing  beneath  the  pleura  on  one  side  displaces  the 
heart  in  the  opposite  direction.  The  cardiac  beat  is  weakened  by  the 
compression,  but,  nevertheless,  transmits  an  impulse  to  the  purulent 
fluid,  which  in  its  turn  conveys  it  outwards  through  the  intercostal 
spaces  in  the  form  of  movements  corresponding  in  rhythm  with  the 
beating  of  the   heart,  so   that   at   first   glance   one   might   imagine   an 


3D2 


t>ERlCARDITlS. 


aneurism  existed  at  the  l)ase  of  the  large  arterial  trunks.  The  lower  pul- 
monary lobe  is  thrust  upwards,  and  over  the  area  of  dulness  pulmonary 
sounds  completely  disappear. 

When  the  heart  is  compressed  by  a  large  hydatid  cyst  or  other  lesion, 
the  general  and  external  symptoms  are  similar  to  those  above  described. 

Finally,  one  last  symptom,  which  api)ears  of  some  importance,  may  be 
mentioned.  When  animals  suffering  from  pericarditis  due  to  a  foreign 
body  are  forced  to  move,  the  beating  of  the  heart  becomes  so  tumultuous 
that  it  can  no  longer  l)e  counted,  and  even  in  a  state  of  rest  it  may  rise  to 


Fig.  182. — Appearance  of  an  animal  suffering  from  pseudo-pericarditis  (infra- 
pericardial  abscess).  The  dotted  outline  indicates  the  space  occupied  by 
the  heart,  which  is  thrust  upwards. 


140  or  150  beats  per  minute.  In  cases  of  pseudo-pericarditis  it  rarely 
rises  above  90  or  110. 

Diagnosis.  The  attempt  to  diagnose  this  condition  accurately  must 
not  be  regarded  merely  as  a  result  of  scientific  curiosity.  Under  certain 
circumstances  the  diagnosis  may  be  of  very  great  importance.  While 
the  patient  affected  with  pericarditis  due  to  a  foreign  body  is  beyond 
all  hope  of  recovery,  certain  cases  of  pseudo-pericarditis  apj)ear  amenable 
to  treatment. 

The  diagnosis,  therefore,  is  of  great  importance,  and  the  practitioner 
should  spare  no  effort  to  confirm  it,  bearing  in  mind  the  symptoms 
enumerated,  and  remembering  that  the  normal  sounds  of  the  heart 
never  completely  disappear. 

An  aseptic  exploratory  puncture  with  a  long,  fine  needle  will  some- 
times prove  of  great  assistance. 


tSEUDO-PERICARDlTlS.  S93 

Prognosis.  Although  grave,  the  prognosis  is  less  so  than  in  true 
pericarditis. 

Treatment.  If  clearly  recognised,  both  suhpleural  and  subperi- 
cardial  abscesses  seem  cm-able.  By  freely  puncturing  the  pus-filled 
cavity  through  an  intercostal  space,  the  liquid  may  be  evacuated  and 
recovery  may  occur.  Healing  is  favoured  by  carefully  washing  out  the 
cavity  with  a  non-irritant  disinfectant. 

The  only  precaution  required  in  making  such  punctures  is  to  avoid 
the  internal  thoracic  artery  and  vein,  the  intercostal  artery,  and  the 
lower  cul-de-sac  of  the  pleura. 


CHAPTER    III. 
ENDOCARDITIS. 

If  the  symptoms  of  pericardial  diseases  are  well  defined,  we  cannot 
say  the  same  of  diseases  of  the  heart,  properly  so-called.  Such  affections 
often  pass  unnoticed,  being  detected  only  on  post-mortem  examination. 
Moreover,  cardiac  diseases  are  rare.  Very  frequently  they  are  only  of  a 
secondary  nature,  accompanying  or  following  better  recognised  condi- 
tions, such  as  infectious  diseases,  post-partum  infections,  etc. 

Causation.  Endocarditis,  i.e.,  inflammation  of  the  endocardium  and 
valves,  is  rarely  primary,  simple  and  benign.  It  was  formerly  thought  to 
be  the  result  of  chills  or  of  the  rheumatic  diathesis.  These  simple  forms 
of  endocarditis  usually  escape  observation,  though  careful  examination  in 
the  first  instance  reveals  them. 

Much  more  frequently,  however,  endocarditis  is  secondary,  malignant, 
infectious  and  infecting.  This  variety  occurs  as  a  comiDlication  of  post- 
partum infection  or  of  very  serious  general  conditions,  such  as  peri- 
pneumonia, gangrenous  coryza,  aphthous  fever,  tuberculosis,  etc.  To 
detect  it,  not  only  must  the  original  disease  be  accurately  diagnosed,  but 
all  the  changes  the  disease  is  producing  in  important  organs  must  be 
followed. 

While  it  is  generally  admitted  that  all  forms  of  endocarditis,  even  of 
the  most  benign  character,  are  originally  due  to  infection,  it  is  certain  that 
in  those  of  the  second  group  the  organisms  which  have  entered  the  blood- 
stream through  a  lesion  of  the  uterus,  lung  or  other  tissue,  are  endowed 
with  very  great  virulence.  They  attack  some  point  on  the  endocardium, 
and  produce  either  ulcerations  which  become  covered  with  fibrous  clots, 
or  exul)eraiit  new  growths  of  a  pathological  nature,  which  generally  are 
papilliform,  fragile,  and  prone  to  become  detached  by  rupture  of  their 
pedicle  and  thus  to  be  launched  into  the  general  circulation  and  to  form 
emboli.  The  surface  of  these  infected  vegetations,  like  that  of  the  ulcera- 
tions, becomes  covered  with  fibrinous  clots,  which  are  readily  loosened, 
form  emboli  in  their  turn,  and  infect  distant  organs. 

Symptoms.  The  general  symptoms  of  infectious  endocarditis  are  by 
far  the  must  important.  They  consist  of  prostration,  loss  of  appetite, 
severe    thirst,  and    high    temperature.     The    local    symptoms    consist 


ENDOCARDITIS.  395 

principally  of  murmurs :  soft  murmurs  due  to  insufficiency  of  the 
auriculo-ventricular  valves,  heard  during  systole,  particularly  opposite 
the  point  of  the  heart  where  the  cardiac  shock  is  most  clearly  felt.  This 
fact  differentiates  them  from  the  murmurs  of  chronic  endocarditis, 
which  are  usually  due  to  aortic  contraction,  and  are  accompanied  by  a 
systolic  sound  heard  at  the  base  of  the  heart,  more  in  advance  and  at 
a  higher  point  than  those  now  under   consideration. 

These  murmurs  or  soutiles  furthermore  vary  in  intensity  and  in 
character,  according  to  whether  the  endocarditis  results  from  post- 
partum infection,  pytemic  disease,  or  some  other  cause. 

Diagnosis.  The  diagnosis  of  endocarditis  has  not  yet  been  the 
object  of  really  careful  study  in  bovine  pathology,  but  there  is  no  doubt 
that  it  can  often  be  detected  by  patient  examination. 

Prognosis.  The  prognosis  is  very  grave,  and  patients  may  die  in 
a  few  days. 

Treatment  comprises  vigorous  local  stimulation  over  the  cardiac 
area,  the  administration  of  antithermic  and  antiseptic  drugs,  such  as 
salicylate  of  soda,  or  of  digitalis,  sparteine  or  other  cardiac  tonics. 

Pathologists  have  also  described,  chiefly  as  post-mortem  curiosities 
of  interest  to  pathological  anatomists,  various  diseases  and  lesions  due 
to  insufficiency  or  contraction  of  the  auriculo-ventricular,  aortic,  and 
j)ulmonary  openings,  lesions  due  to  infectious  myocarditis,  to  the  pre- 
sence of  parasites  and  to  other  causes. 

The  symptoms  of  these  various  diseases  or  lesions  in  bovine 
animals  are  still  too  imperfectly  understood  to  permit  of  more  than 
a  very  limited  description. 

In  the  present  state  of  our  knowledge,  diagnosis  would  always  be 
of  an  uncertain  character,  and  for  this  reason  we  do  not  propose  to 
deal  with  them  at  present. 


CHAPTER    IV. 

DISEASES    OF    BLOOD-VESSELS. 

■  Diseases  of  vessels,  arteries  or  veins,  in  animals  of  the  bovine  and 
ovine  species  are  frequently  nothing  more  than  localisations  of  grave 
general  disorders,  and  rarely  admit  of  treatment.  This  is  specially  the 
case  in  regard  to  arteries,  hut  a  study  of  the  diseases  of  veins  has  some 
practical  importance. 

PHLEBITIS. 

Phlebitis,  i.e.,  inflammation  of  a  vein,  is  of  interest  only  in  the  case 
of  bovine  animals.  In  them  certain  conditions  may  occur  which  the 
practitioner  should  understand,  with  a  view  either  to  prevention  or  treat- 
ment. Inflammation  of  the  veins  may  be  due  to  external  causes,  such  as 
surgical  or  accidental  wounds  (phlebotomy  wounds,  accidental  wounds, 
local  inflammations,  etc.),  or  to  infernal  causes  of  infectious  origin 
(general  infection,  puerperal  infection,  etc.). 

ACCIDENTAL    PHLEBITIS. 

The  jugular  vein  may  become  inflamed  as  a  result  of  accidental 
wounds  or  of  phlebotomy,  but  the  mammary  vein  in  cows  is  much  more 
frequently  affected.  In  both  cases  the  disease  is  due  to  infection  of  the 
clot  which  seals  the  vessel ;  it  may  assume  the  form  of  either  adhesive 
phlebitis  or  suppurative  phlebitis.  Whether  produced  directly  by  the  use 
of  infected  instruments  or  whether  it  is  of  a  secondary  character,  trace- 
able to  the  clot  being  infected  by  germs  entering  from  without  being 
conveyed  to  the  wounds  by  the  head-stall  chains,  by  litter,  manure,  etc., 
the  result  is  the  same.  The  inflammation,  at  first  confined  to  the 
endothelium,  extends  to  the  wall  of  the  vein  and  causes  fibrin  to  be 
precipitated  over  the  inner  wall  of  the  inflamed  vein  for  a  distance 
varying  with  each  case. 

If  the  micro-organisms  do  not  produce  suppuration,  the  vein  appears 
simply  thrombosed  and  inflamed,  the  phlebitis  remains  of  an  adhesive 
character,  and  may  disappear  sj)ontaneously,  provided  the  animal  be  kept 
quiet.  If,  on  the  other  hand,  suppuration  is  set  up,  the  clot  gradually 
breaks  down,  the  internal  surface  of  the  vein  develops  granulations  and 


ACCIDENTAL    PHLEBITIS.  397 

undergoes  suppuration,  and  the  phlebitis  is  then  said  to  become  suppura- 
tive. The  clot  may  even  become  entirely  detached,  transforming  the 
suppurative  phlebitis  into  a  very  grave  form  of  hsemorrhagic  phlebitis. 

The  jugular  is  the  commonest  seat  of  adhesive  phlebitis,  the  mam- 
mary vein  of  suppurative  phlebitis. 

Symptoms.  The  symptoms  are  easy  to  recognise.  The  accidental  or 
instrumental  wound  is  the  seat  of  a  painful  oedematous  swelling.  It  dis- 
charges a  reddish  offensive  serosity,  or  exhibits  blackish-violet  bleeding 
granulations  surrounding  a  little  central  sinus. 

The  affected  vein,  whether  the  jugular  or  mammary,  soon  becomes 
swollen,  is  sensitive  to  the  touch  and  very  rapidly  becomes  indurated 
in  the  direction  of  its  origin  for  a  greater  or  less  distance. 

Phlebitis  has  then  set  in,  and  according  as  one  or  other  complication 
predominates,  it  is  described  as  suppurative  or  hfemorrhagic. 

Diagnosis  and  prognosis.  The  diagnosis  presents  no  difficulty.  In 
phlebitis  of  the  jugular  the  neck  is  held  stiffly,  and  the  jugular  furrow  is 
partly  obliterated. 

The  prognosis  is  somewhat  serious,  particularly  in  phlebitis  of  the 
mammary  vein,  for  obliteration  of  the  vein  interferes  with  the  function 
of  the  venous  plexus  from  which  it  springs,  and,  although  there  may 
be  a  limited  vicarious  circulation,  the  secretion  of  milk  is  indirectly  and 
secondarily  checked  owing  to  difficulty  of  irrigation. 

The  extension  of  phlebitis  of  the  jugular  towards  the  head  and  the 
venous  sinuses  of  the  cranial  cavity,  is  quite  exceptional. 

When  the  mammary  vein  is  inflamed  it  appears  collapsed  in  the 
direction  of  the  heart  and  swollen,  indurated,  and  painful  in  that  of 
its  origin  in  the  mammary  gland. 

Treatment.  The  first  point  requiring  attention  is  so  to  fix  the 
animal  as  to  prevent  the  clot  from  being  pressed  upon  or  crushed, 
though,  unfortunately,  this  cannot  always  be  properly  done.  The  diffi- 
culty is  obviated  by  applying  vesicants,  which  cause  swelling  and  pain, 
and  so  reduce  natural  movement  of.  the  parts  to  a  minimum. 

At  first,  when  the  parts  surrounding  the  operative  wound  are  simply 
swollen  and  phlebitis  is  threatened,  repeated  application  of  tincture 
of  iodine  or  a  liquid  vesicant  is  useful,  and  may  prevent  the  disease 
developing. 

In  existing  cases  a  blister  applied  over  and  around  the  whole  of 
the  hardened  tract  may  prevent  the  mischief  from  proceeding  beyond 
the  adhesive  stage.  In  such  case  the  clot  becomes  organised,  the  vein 
remains  obliterated,  and  recovery  follows. 

Similar  treatment  may  also  be  employed  in  suppurative  phlebitis, 
but  as  the  clot  gradually  breaks  down  in  consequence  of  the  action  of 
bacteria  it  is  useful  and  almost  indispensable  to  disinfect  the  vessel.   For 


398  DISEASES    OF    BLOOD-VESSELS.  • 

this  purpose  the  openmg  of  the  sinus  must  be  enlarged,  and,  by  means  of 
a  sterilised  or  very  clean  syringe  with  a  curved  nozzle,  the  parts  washed 
out  daily  with  warm  boiled  water,  followed  by  an  antiseptic  injection 
containing  2  per  thousand  of  iodine,  3  per  cent,  of  carbolic  acid,  or, 
better  still,  glycerine  containing  1  per  thousand  of  sublimate. 

If  in  spite  of  this  treatment  the  phlebitis  extends  towards  the  origin 
of  the  jugular  or  mammary  vein,  a  counter-opening  may  be  made  at  the 
point  where  the  clot  still  remains  adherent,  and  a  strip  of  iodoform  gauze 
saturated  with  tincture  of  iodine  or  with  blistering  ointment  diluted  to 
one-eighth  with  oil  may  be  passed.  Needle  firing  is  also  of  value. 
Finally,  as  a  last  resource,  a  ligature  may  be  applied  to  the  vein  above 
or  beyond  the  clot. 

This  operation,  which  in  the  horse  is  confined  to  hpemorrhagic 
phlebitis,  is  especially  applicable  to  phlebitis  of  the  mammary  vein  in 
the  cow.  As  the  vein  is  subcutaneous,  the  operation  may  easily  be 
performed  in  the  standing  position ;  the  successive  stages  are  as 
follows : — 

The  patient  is  firmly  secured  and  its  hind  limbs  hobbled  by  passing 
a  rope  around  the  hocks  in  a  figure  of  eight.  It  is  steadied  on  one 
side  by  an  assistant  who  presses  on  the  quarter. 

One  cubic  centimetre  of  a  10  per  cent,  solution  of  cocaine  is  sub- 
cutaneously  injected  on  each  side  of  the  vein  at  the  point  chosen.  Ten 
minutes  later  a  button-hole  incision  is  made  through  the  skin  and  a  loop 
of  thick  catgut  passed  around  the  vein  by  means  of  a  curved  needle. 
The  ligature  is  tied  firmly  with  a  surgical  knot  and  the  little  wound 
afterwards  covered  with  a  mass  of  cotton  wool  secured  by  collodion. 

INTERNAL    INFECTIOUS    PHLEBITIS    (UTERO-OVARIAN    PHLEBITIS). 

The  internal  forms  of  phlebitis  of  parasitic  or  infectious  origin  are  as 
yet  little  understood,  but  mention  may  be  made  of  phlebitis  of  the  utero- 
ovarian  veins  which  frequently  follows  parturition  and  post-partum  in- 
fection. This  is  probably  in  many  instances  the  real  cause  of  the  post- 
partum paraplegia  without  gross  or  apparent  material  lesions. 

This  form  of  infectious  phlebitis  may  extend  to  the  large  internal  and 
external  iliac  veins  and  produce  embolism  and  septicaemia,  as  is  shown 
by  recorded  cases. 

The  mechanism  of  the  disease  is  easily  understood.  The  infective 
agents  penetrate  the  veins  of  the  uterine  mucous  membrane  and  pass 
from  the  lumen  into  the  wall  of  the  vein.  Here  they  cause  inflammation 
of  the  vascular  endothelium,  followed  by  the  deposit  of  a  fibrous  clot  of 
cylindrical  form,  which  sets  up  partial  thrombosis  of  the  vein.  This 
thrombosis  becomes  complete  by  the  formation  of  a  central  clot  due 
to  venous  stasis. 


UMBILICAL    PHLEBITIS    OF    NEW-BORN    ANIMALS.  399 

It  is  not  necessary  for  the  germs  to  penetrate  at  a  number  of  points. 
The  thrombosis  progresses  until  it  gains  a  large  trunk  beyond  the 
original  point  of  infection. 

Symptoms.  Phlebitis  of  the  veins  of  the  pelvis  is  frequently  mis- 
understood or  overlooked,  because  the  practitioner  is  apt  to  confine  his 
attention  to  external  signs,  the  paresis  and  paraplegia  of  the  hind 
quarters. 

The  symptoms  usually  appear  from  five  to  eight  days  after  normal 
parturition  or  parturition  in  which  there  is  retention  of  the  after-birth 
followed  by  metritis.  The  animals  show  fever  and  lose  appetite,  signs 
which  may  be  due  to  metritis,  but  soon  after  they  experience  difficulty 
in  rising,  and  some  days  later  remain  permanently  recumbent. 

The  circulation  is  weak,  and  the  entire  intra-pelvic  region  painful ; 
the  large  nervous  trunks  are  affected,  exertion  becomes  difficult,  and  the 
animals  refuse  to  rise.     At  this  stage  they  should  not  be  forced  to  do  so. 

In  two  to  three  weeks  improvement  may  occur  and  lead  to  recovery 
but  in  many  instances  various  complications  in  the  nature  of  purulent 
infection  or  septicemia  set  in,  or  the  animals  are  previously  slaughtered. 

Diagnosis.  The  diagnosis  can  only  be  determined  after  the  symp- 
toms develop.  Confirmation  might  in  some  cases  be  obtained  by 
rectal  exploration  made  methodically  and  gently. 

Prognosis.     The  prognosis  is  grave. 

Treatment.  Treatment  should  be  based  on  disinfection  of  the  uterus 
by  injections  of  boiled  water  or  warm  iodised  solutions  and  drainage  by 
means  of  strips  of  iodoform  gauze.  The  animals  should  be  placed  on  a 
thick  and  scrupulously  clean  bed,  and  as  far  as  possible  be  spared  any 
considerable  exertion  for  a  fortnight.  By  changing  their  position  once 
or  twice  a  day  complications  may  be  avoided. 

UIMBILICAL    PHLEBITIS    OF    NEW-BORN    ANIMALS. 

One  of  the  most  serious  conditions  met  with  in  practice  is  that 
known  as  umbilical  phlebitis  of  new-born  animals.  Whilst  in  fact  it  is 
easy  to  deal  with  phlebitis  of  the  jugular  or  mammary  vein,  surgical  or 
medical  assistance  becomes  extremely  difficult  in  this  case,  because  the 
inflamed  vein  is  deeply  situated  in  the  abdomen  and  passes  through  one 
of  the  most  important  internal  organs,  viz.,  the  liver.  When  it  is  added 
that  umbilical  phlebitis  is  in  95  per  cent,  of  cases  of  a  suppurative 
character,  the  reader  may  form  some  idea  of  its  gravity. 

Unless  the  condition  is  early  diagnosed  and  measures  are  at  once 
taken,  such  complications  as  infectious  hepatitis,  purulent  infection, 
and  septicaemia  cannot  be  avoided.     Death  is  then  inevitable. 

In  order  clearly  to  understand  this  phlebitis,  however,  it  is  necessary 


400 


DISEASES   OF   BLOOD-VESSELS. 


to  recall  the  aiiatoiiiical  formation  of  the  umhihcal  region  in  the  new- 
born animah 

At  birth  the  umbiHeal  cord  is  represented  by  a  cyHndrical  mass, 
surrounded  by  the  terminal  portion  of  the  amnion.  It  enters  the 
abdomen  through  a  circular  perforation  in  the  abdominal  wall  known 
as  the  umbilical  ring.  This  ring  may  be  divided  into  two  parts,  one 
deeply  seated,  the  fibro-aponeurotic  ring,  consisting  of  an  aperture  in 


Ro.       ^  g 


Fig.  188. — I'osition  of  the  abdominal  viscera  in  a  new-l)orn  annual:  E»,  vunien  ; 
E,  epiploon;  lig,  left  kidney;  Ig,  small  intestine;  C,  abomasum  ;  U,  ureter; 
0,  urachus  ;  R,  rectum.  Umbilical  cord  :  Vo,  Umbilical  vein  ;  Aa,  allantoid 
arteries;    Ya,  allantoid  veins  ;    O,  the  urachus. 


the  white  line ;  the  other  the  superficial  or  cutaneous  ring,  formed 
by  the  skin,  which  is  wrinkled  all  round  it,  and  constitutes  a  kind  of 
sleeve  about  an  inch  in  length.  This  cutaneous  sleeve  is  continuous 
with  the  amniotic  tissues.  The  entire  umbilical  cord  is  therefore 
enveloped  in  an  amniotic-cutaneous  sheath. 

It  is  composed  of  four  principal  structures — the  umbilical  arteries, 
the  umbilical  vein,  the  urachus,  and  the  interstitial  mucous  tissue. 

The  umbilical  arteries  and  vein  consist  of  two  parts — the  extra-foetal 
part,  which  co-operates  in  forming  the  cord,  and  the  intra-fatal  part. 


UMBELICAL    PPILEBITIS   OF   NEW-BORN   ANIMALS.  401 

The  first  is  formed  of  two  arteries  and  two  veins,  in  contra-dis- 
tinction  to  the  condition  in  soHpeds,  where  the  cord  only  contains  one 
vein.  In  the  second,  the  arrangement  is  as  follows :  The  two  mnbilical 
allantoid  arteries  on  entering  the  abdomen  curve  backwards  towards  the 
entry  of  the  pelvis,  passing  over  the  sides  of  the  bladder  enveloped  in 
the  lateral  ligaments,  and  extend  upwards  towards  the  bifurcation  of  the 
aorta,  finally  pouring  their  contents  into  the  internal  iliac  arteries.  In 
the  adult  they  may  still  he  traced  as  annexes  of  these  latter  vessels. 
The  two  umbilical  veins  on  passing  through  the  ring  unite  to  form  one 
within  the  abdomen.  This  vessel  passes  forwards,  rising  along  the 
lower  al)d()minal  wall,  then  becomes  lodged  in  the  thickness  of  the 
inferior  middle  ligament  of  the  liver,  and  finally  penetrates  that  organ 
where  it  unites  with  the  portal  vein.  It  is  also  connected  with  a  vessel 
known  as  "  the  vein  of  Arantius,"  which  places  it  in  connnunication  with 
the  posterior  vena  cava,  a  vein  not  found  in  sohpeds. 

The  fcBtal  blood  is  purified  by  exchanges  between  it  and  that  circu- 
lating in  the  maternal  placenta,  and  when  I'e-arterialised  it  returns  by 
the  umbilical  vein. 

The  urachus,  found  in  the  embryo  and  foetus,  eventually  gives  rise 
to  the  bladder.  In  new-born  animals  this  viscus  is  therefore  open  at 
its  base,  and  communicates  with  the  allantoid  cavity  through  the 
urachus.  The  urachus  starts  from  the  base  of  the  bladder,  and,  extend- 
ing along  the  median  plane  of  the  lower  abdominal  wall  between  the  two 
umbilical  arteries  as  far  as  the  umbilical  opening,  takes  its  place  in  the 
cord  alongside  the  vessels.  Through  it  the  secretions  of  the  fcetal 
kidneys  drain  into  the  allantoid  cavity.  The  interstitial  mucous  tissue, 
also  called  "  Wharton's  jelly,"  is  a  gelatinous  material  which  unites 
these  different  vessels  and  helps  to  support  and  protect  them  in  the 
umbilical  cord.     It  is  particularly  abundant  opposite  the  umbilicus. 

Innnediately  after  birth  the  umbilical  cord  ruptures  of  itself  as  a 
result  of  the  fall  which  the  young  animal  experiences  or  of  movements 
made  by  the  mother,  as  for  instance  when  she  attempts  to  rise.  In 
certain  other  cases  it  is  divided  by  the  mother  biting  it,  or  it  may  be 
ligatured  by  some  person  present.  However  the  rupture  may  be 
brought  about,  it  always  occurs  at  a  distance  of  2  to  4  inches  from  the 
umbilicus.  The  immediate  result  is  to  produce  thrombosis  of  the 
umbilical  vessels  and  obstruction  of  the  urachus.  The  two  umbilical 
arteries  rarely  bleed,  for  htemostasis  is  brought  about  by  stretching, 
and  these  arteries,  being  very  elastic,  almost  immediately  retract  and 
close.  The  umbilical  veins  simultaneously  become  blocked,  and  the 
single  intra-abdominal  vein  having  no  further  raison  (Vetrc,  gradually 
becomes  obliterated.  The  urachus  should  normally  be  obHterated  at 
the   moment  of   delivery   (Colin  and    Saint-Cyr),  or  at  any  rate  soon 


D.C. 


D  D 


402  DISEASES   OF   BLOOD-VESSELS. 

afterwards,  as  a  consequence  of  rupture  of  the  cord  (Chauveau  and 
Zundel). 

Immediately  after  delivery  another  change  sets  in.  The  extra-foetal 
portion  of  the  cord,  which  remains  attached  to  the  umbilicus,  dries  on 
contact  with  the  air,  the  Wharton's  jelly  retracts,  the  whole  undergoes 
a  kind  of  necrosis,  assumes  the  appearance  of  a  dry  scab,  and  in  eight  or 
ten  days  falls  awaj',  leaving  in  its  place  the  umbilicus,  which  should  be 
half  cicatrised  on  the  fall  of  the  cord.  Thus  the  umbilical  cord  presents 
an  extra-fcetal  degenerated  portion  and  a  persistent  portion  about  h  to 
1  inch  only  in  length,  buried  in  the  cutaneous  ring  of  the  umbilical 
region. 

If  all  the  changes  indicated  occur  normally  and  physiologically,  the 
little  wound  in  the  region  of  the  umbilicus  cicatrises  in  a  perfectly 
regular  way.  But  unfortunately  this  is  not  always  the  case.  At  times 
the  cicatrix  becomes  contaminated  by  manure,  urine  or  dust,  suppurates, 
and  may  then  become  the  seat  of  various  complications,  such  as  um- 
bilical i^hlebitis,  omphalitis  or  persistence  of  the  canal  of  the  urachus. 

UMBILICAL    PHLEBITIS    OR    OMPHALO-PHLEBITIS. 

History.  Umbilical  phlebitis,  and  in  a  more  general  sense  all  patho- 
logical conditions  of  the  umbilicus,  in  new-born  animals  have  been  the 
object  of  numerous  investigations  by  Lecoq,  Benard,  Loiset  (1843), 
Bollinger  (1874);  and  more  recently  by  Morot  (1884),  Uffredizzi  (1884), 
Chassaing  (1886),  etc. 

Omphalo-phlebitis  may  occur  as  a  primary  condition  or  may  appear 
as  a  complication  of  omphalitis  and  of  persistence  of  the  urachus.  It 
consists  essentially  in  suppurating  inflammation  of  the  umbilical  vein, 
but  is  not  infrequently  accompanied  by  omphalitis,  arteritis,  peritonitis, 
and  cystitis. 

Causation.  The  disease  results  from  infection  of  the  (normal)  clot 
and  of  the  wound  resulting  from  severance  of  the  cord.  The  infection 
may  only  cause  simple  phlebitis  of  the  umbilical  vein,  but  if  the 
organisms  are  virulent  the  phlebitis  almost  inevitably  degenerates  into 
suppurative  phlebitis. 

Formerly  omphalo-phlebitis  was  thought  to  be  caused  by  the 
mother  licking  the  foal,  by  irregular  tearing  of  the  cord,  by  crushing 
and  separation  of  the  obliterating  clot,  etc.  The  truth  is  that  all  these 
causes  favour  infection  of  the  umbilical  wound,  which  is  the  primary 
cause,  suppurative  phlebitis  being  secondary  only. 

When  the  cord  is  ruptured  both  the  veins  and  arteries  become 
plugged,  and  bleeding  ceases.  This  plugging  should  end  in  organisation 
of  the  clot  and  obliteration  of  the  vessels.     If,  however,  the  wound  is 


UMBILICAL    PHLEBITIS    OR    OMtHALO-I'HLEBITIS.  403 

infected,  micro-organisms  make  their  way  between  the  clot  and  walls, 
and  extend  along  the  inner  surface  of  the  vein,  infecting  first  the  clot 
and  then  the  vein,  and  thus  setting  up  suppurative  phlebitis. 

If  suppuration  does  not  continue,  recovery  may  occur  spontaneously. 
Infection  may  be  confined  to  the  clot,  producing  simple  phlebitis,  but  it 
often  extends  along  the  umbilical  vein  to  the  liver,  causes  infectious 
hepatitis  and  purulent  infection  or  septicaemia.  Similar  results  may  be 
produced  by  infection  of  the  arteries,  the  organisms  making  their  way 
as  far  as  the  bifurcation  of  the  aorta,  and  thus  gaining  the  general 
circulation.  Moussu  believes  that  this  is  the  commonest  method  by 
which  sei^tica'mia  is  produced  in  calves. 

Symptoms.  In  these  cases  it  is  usually  the  general  symptoms  which 
first  attract  attention,  the  local  lesion  passing  unnoticed  for  a  greater 
or  less  time. 

The  animal  shows  intense  fever,  due  to  either  suppurative  phlebitis, 
infectious  hepatitis,  or,  as  often  happens,  to  generalised  infection. 
Appetite  is  lost,  diarrhcBa  is  abundant,  the  respiration  and  circulation 
are  accelerated,  and  the  temperature  rises  to  104^  Fahr.,  or  even 
105°  Fahr. 

The  local  symptoms  are  those  usually  associated  with  omphalitis  or 
phlebitis.  An  examination  of  the  umbilical  ring  reveals  an  cedematous, 
hot,  sensitive  swelling,  the  lower  part  of  which  exhibits  a  chronic,  sup- 
purating, fungoid,  blackish  wound  o£  unhealthy  appearance. 

This  wound  is  the  seat  of  one  or  more  sinuses  which  penetrate  the 
vein,  arteries,  or  urachus.  If  only  one  sinus  exists,  it  always  passes 
upward  and  forward  into  the  umbilical  vein.  The  utmost  precaution 
should  be  employed  in  examining  the  parts.  Should  it  be  thought 
desirable  to  probe  the  sinus  in  order  to  discover  its  direction,  the  probe 
must  be  very  cautiously  introduced,  and  only  for  a  short  distance, 
because  rough  handling  would  tear  the  tissues  and  carry  infective 
material  to  deeper  seated  points. 

Complications.  These  are  numerous  and  very  grave.  Long  ago 
Lecoq  described  a  disease  suggestive  of  laminitis,  which  beyond  doubt 
was  only  a  form  of  purulent  infection.  At  a  later  date  Loiset  studied 
a  disease  following  omphalitis,  in  which  interstitial  abscesses  deve- 
loped in  the  cord.     This  also  was  simply  purulent  infection. 

More  recently  complications  such  as  pleurisy,  pneumonia,  infectious 
endocarditis,  diarrhoeic  enteritis,  and  especially  suppurative  polyarthritis 
of  young  animals  have  been  referred  to  omphalo-phlebitis.  All  these 
complications  result  from  infection.  The  micro-organisms  themselves 
or  the  toxins  they  secrete  appear  to  have  a  particularly  injurious  action 
on  the  serous  membranes,  a  fact  which  throws  light  on  the  frequency  of 
such  complications  as  pleurisy,  peritonitis,  endocarditis  and  arthritis. 

D  D    2 


404  DISEASES   OF   BLOOD-VESSELS. 

Intoxication  also  plays  a  certain  part,  and  microhic  toxins  are 
responsible,  at  least  at  first,  for  the  uncontrollable  diarrlicea,  arthritis 
with  sterile  exudations,  etc. 

Diagnosis.  This  presents  no  difficulty.  The  alarming  general  symp- 
toms seen  at  the  outset  immediately  suggest  in  the  case  of  3'oung  animals 
the  possibility  of  disease  in  the  umbilical  region. 

Prognosis.  The  prognosis  is  grave,  it  may  be  said  very  grave, 
because  treatment  is  difficult  to  apply,  and  dangerous  complications, 
which  almost  always  prove  fatal,  may  already  have  been  set  up. 

One  must  always  distinguish,  however,  and  take  into  account  in 
forming  the  prognosis,  the  special  characteristics  of  the  phlebitis,  and 
weigh  carefully  the  signs  of  complication.  The  fistula  should  be 
cautiousl}^  explored,  and  its  depth,  etc.,  noted,  while  the  temperature, 
circulation,  respiration,  etc.,  should  be  carefully  studied. 

Treatment.  A  very  important  item  of  treatment  consists  in  regu- 
larly and  scrupulously  cleansing  the  region  of  the  umbilicus  after  the 
cord  has  separated  and  until  the  wound  has  completely  cicatrised. 
The  parts  are  washed  with  boiled  water  and  dusted  with  boric  acid, 
iodoform,  etc. 

A  still  better  plan,  and  one  that  almost  certainl}'  guards  against  this 
disease,  is  to  apply  an  antiseptic  dry  dressing  as  soon  as  the  new-born 
animal  has  become  dry.  This  need  only  consist  of  a  small  sheet  of 
antiseptic  cotton  wool  fixed  to  the  umbilicus  by  four  pitch  bandages 
or  by  two  pieces  of  webbing  passed  over  the  back.  In  this  way  con- 
tamination of  the  cord  and  the  risk  of  infection  are  avoided. 

In  cases  of  fully-developed  phlebitis  the  old  generation  of  practitioners 
used  to  recommend  local  dressings  with  adhesive  plasters,  astringent 
and  vesicant  applications,  etc.  All  such  methods  are  useless,  because 
they  only  act  on  a  part  of  the  diseased  structures  and  cannot  reach  the 
blind  ends  of  the  sinuses.  The  classic  treatment  of  suppurative  phlebitis 
also  is  out  of  the  question. 

All  that  can  be  done,  therefore,  is  slightly  to  open  up  the  sinuses 
and  wash  them  out  frequently  with  antiseptic  solutions,  such  as  boiled 
water,  sublimate-glycerine,  carbolic  glycerine,  etc.,  afterwards  apply- 
ing antiseptic  dressings.  These  methods,  however,  are  scarcely  likely 
to  put  an  end  to  infectious  complications  such  as  suppurative  poly- 
arthritis. 

There  is  no  danger  in  using  strong  carbolic  solution,  3  per  cent, 
creolin,  4  per  cent,  chloride  of  zinc,  sulphate  of  copper,  etc.  Should  there 
be  several  sinuses  and  should  one  of  them  extend  in  a  backward  direction, 
it  is  necessary  to  make  certain  that  no  communication  exists  between 
the  urachus  and  the  bladder.  For  this  purpose  some  boiled  water  may 
be  injected  into  the  sinus.      If  a  communication  exist,  this  water  will 


UMBILICAL    PHLEBITIS    OR    OMPHALO-PHLEBITIS.  405 

fill  the  bladder  and  distend  the  urachus.  The  treatment  necessary  in 
this   case   is  similar  to  that  of  persistence  of  the  urachus. 

It  is  well  in  all  cases  to  be  guided  by  the  following  principle  : 
never  to  resort  to  treatment  unless  suppuration  has  occurred  and  the 
sinus  is  blind.  To  check  suppuration  a  blister  may  be  applied  around 
the  umbilical  region  while  means  are  taken  to  prevent  the  animal 
licking  the  parts. 

Chassaing  in  1886  suggested  a  rather  original  method  of  operation 
which  deserves  description.  It  is  founded  on  the  permanent  treatment 
of  sinuses,  and  consists  in  introducing  a  flexible  osier  stick,  a  kind  of 
bougie,  enveloped  in  tow  and  moistened  with  the  following  mixture  : 

Collodion  .  .  .  .  .  .  .  .  .  .  .  .  .  .      3  parts. 

Sublimate  .  .  .  .  .  .  .  .  .  .  .  .      1  part. 

This  is  introduced  for  a  distance  of  3  to  4  inches  into  the  fistula,  and 
is  fixed  to  the  skin  with  gutta-percha  or  pitch.  The  dressing  is  renewed 
every  five  or  six  days,  and  healing  takes  place,  it  is  said,  in  one,  two, 
or  at  most  three  weeks. 

It  is  very  likely  that  if  the  sinuses  were  previously  cleared  and 
simply  plugged  with  antiseptics  or  treated  by  introducing  pencils  of 
salol,  nitrate  of  silver,  sulphate  of  copper,  iodoform,  etc.,  at  least  as 
good  results  might  be  obtained. 


CHAPTER     V. 
DISEASES    OF    THE    BLOOD. 

SEPTICi«:MIA    OF    NEW'BORN    ANIMALS. 

The  above  title  is  given  to  that  exceedingly  fatal  disease  commonly 
known  as  "  white  scour,"  etc.,  the  mortality  in  which  often  rises  to 
95  per  cent. 

The  disease  was  studied  by  Poels  in  Holland  in  1889,  Dele  in 
Belgium  in  1891,  Perroncito  in  Italy,  Galtier  in  the  centre  of  France 
in  1891 — 92,  and  quite  recently  by  Nocard  in  Ireland  in  1901. 

It  occurs  throughout  all  the  breeding  districts  of  France,  and  in  some 
parts  causes  enormous  losses,  the  mortality  comprising  two-thirds  or 
even  three-fourths  of  all  new-born  calves.  In  certain  breeding  estab- 
lishments in  Normandy  all  the  new-born  animals  without  exception 
die  unless  special  precautions  are  adopted. 

In  foals,  septicaemia  of  the  new-born  is  very  rare,  because  horse- 
breeding  establishments  are  much  better  cared  for,  and  breeding  mares 
are  segregated.  In  byres,  on  the  other  hand,  the  greatest  promiscuity 
exists.  The  disease  is  equally  uncommon  in  lambs,  although  it  makes 
numerous  victims  in  folds  which  have  once  been  attacked.  It  is,  how- 
ever, quite  common  in  young  pigs. 

Symptoms.  The  development  and  course  of  the  disease  are  in 
certain  respects  characteristic. 

The  disease  usually  appears  within  two  or  three  days  after  birth,  and 
only  in  rare  cases  after  the  second  week.  Calves  which  at  birth  appeared 
vigorous  and  in  good  health  are  found  dull  on  the  second  day  ;  after  the 
second  or  third  meal  they  suffer  from  diarrhcea,  and  from  that  time 
refuse  all  nourishment,  lie  down  as  though  exhausted,  and  sometimes 
die  very  rapidly. 

Some  even  perish  in  ten  to  twelve  hours  without  showing  diarrhoea ; 
altliough  apparently  well  at  night,  they  are  found  dead  or  dying  the  next 
morning.     This  is  the  peracute  form. 

Most  frequently  the  young  creatures  suffer  for  two  or  three  days, 
sometimes  a  week.  Appetite  is  partly  preserved;  at  first  the  diar- 
rhoea resembles  that  due  to  inability  to  digest  milk,  but  the  feeces  soon 


SEPTICEMIA    OF    NEW-BORN    ANIMALS.  407 

become  greyish  or  blackish  and  very  foetid.  The  hair  of  the  tail, 
quarters  and  hocks  is  soiled  and  matted,  the  skin  irritable  and  reddish ; 
the  patients  lose  strength,  appear  unsteady  on  their  limbs,  and  develop 
rapid  respiration  and  tumultuous  action  of  the  heart.    . 

They  take  little  food,  become  weaker  by  degrees,  and  die  in  a  con- 
dition of  exhaustion. 

Fever,  well  marked  at  first,  frequently  diminishes,  and  the  tempera- 
ture may  remain  normal  for  several  days,  falling  to  97°  Fahr.,  or  even 
95°  Fahr.,  twenty-four  hours  before  death. 

This  is  the  commonest  form  of  the  disease.  It  lasts  three  to  five 
days,  and  is  always  grave. 

Cattle-men  recognise  the  disease  chiefly  by  the  diarrhoea  and  loss  of 
appetite. 

I^astly,  a  third  and  rarer  form  occurs  during  which  appetite  is  main- 
tained in  spite  of  the  diarrhoea.  The  animals  remain  thin,  develop 
poorly,  but  survive  for  a  month,  six  weeks  or  two  months.  The  diarrhoea 
diminishes  or  disappears,  but  its  disappearance  is  followed  by  complica- 
tions such  as  broncho-})neumonia,  pleuro-pneumonia,  endocarditis,  acute 
arthritis,  etc.,  a  fact  which  led  Prof.  Galtier  to  give  the  disease  the  name 
of  "  septic  pleuro-pneumonia  in  calves."  These  complications,  again,  are 
extremely  grave,  and  generally  prove  fatal  after  a  period  of  varying 
length.  They  are  due  to  local  development  of  micro-organisms  of  the 
kind  which  produce  septicaemia,  and  similar  to  those  described  under  the 
name  of  broncho-pneumonia  of  intestinal  origin  in  sucking  calves. 

They  differ,  however,  as  regards  their  cause,  from  the  primary  affec- 
tion, and  may  be  due  to  very  varied  organisms,  the  commonest  being 
those  of  suppuration.  These  organisms,  in  fact,  are  alien  to  the  primary 
disease,  and  obtain  entrance  from  without,  very  probably  by  the  tracheo- 
bronchial tract. 

In  young  pigs  septicpemia  assumes  the  same  forms  as  in  the  calf. 
In  lambs  the  chronic  form  seems  more  frequent  than  the  peracute 
and  the  ordinary  forms. 

Causation.  The  septicaemia  of  calves,  and  possibly  of  all  new-born 
animals,  of  whatever  species,  is  produced  by  a  microbe  which  flourishes 
in  the  manure  and  litter  of  stables,  and  which  Nocard  included  in  the 
group  of  Pasteurella.  It  can  be  found  in  the  blood  from  the  moment  the 
flrst  external  symptoms  appear  until  the  time  of  death.  During  the  last 
hours,  however,  the  bacterium  Coli  communis  also  invades  the  circulation 
in  many  instances,  and  if  cultures  are  not  made  until  some  hours  after 
death,  the  colon  bacillus  and  bacteria  of  putrefaction  aie  more  particu- 
larly discovered. 

The  microbe  of  calf  septicaemia  can  be  readily  cultivated  in  jelly  or  in 
ordinary  liquid  media.     Injected  into  the  veins  of  experimental  animals, 


408  DISEASES   OF  THE   BLOOD. 

it   reproduces   the  clinical   symptoms,   and  causes  death   more   or   less 
rapidly,  according  to  the  dose  injected. 

The  virulence  of  cultures  grown  in  defibrinated  calf's  hlood  seems 
more  intense,  and  Moussu  has  been  able  to  reproduce  the  clinical  form 
of  the  disease  by  applying  to  the  umbilical  cord  of  a  new-born  animal  a 
pledget  of  cotton  wool  saturated  with  su^h  a  culture,  and  covering  it  with 
a  dressing.  The  germs  of  the  disease  are  spread  throughout  the  byres 
through  the  medium  of  faeces.  When  the  umbilical  cord  has  become  dry, 
that  is,  after  the  third  day,  the  application  of  virulent  cultures  to  the 
stump  no  longer  causes  infection. 

Pathogeny.  The  pathogeny  of  this  septicaemia  of  calves  and  of  new- 
born animals  is  easy  to  explain. 

At  birth  the  young  animals  fall  on  the  litter,  and  the  uml)ilical  cord 
becomes  contaminated.  The  infective  agent,  finding  an  excellent  culture 
medium  in  the  tissues  of  the  cord,  at  once  begins  to  develop,  increases  in 
enormous  numbers,  steadily  ascends  along  the  cord,  and  sets  up  septi- 
caemia. It  grows  in  the  gelatinous  Wharton's  jelly  and  in  the  fibrinous 
plug  closing  the  arteries  and  umbilical  vein,  and  soon  enters  the  true 
circulation.  Septicaemia  is  then  fully  established,  general  disturbance 
sets  in,  and  with  it  the  diarrhoea  by  which  it  is  externally  indicated. 

It  is  important  to  remember,  however,  that  infection  occurs  most 
readily  through  the  medium  of  the  cord,  and  during  the  first  few  days 
after  birth :  it  may  occasionally  be  brought  about  towards  the  eighth 
or  tenth  day,  when  the  shrivelled  portion  of  the  cord  falls ;  in  this  case 
its  entrance  is  effected  through  the  little  umbilical  wound. 

Lesions.  The  lesions  are  sometimes  so  obscure  that  the  practitioner 
may  hesitate  to  deliver  an  opinion. 

In  acute  cases,  where  death  occurs  in  two  or  three  days,  or  even  in 
ten  to  twelve  hours,  post-mortem  examination  reveals  only  increased 
vascularity  of  the  serous  membranes — the  peritoneum,  pleura,  jjeri- 
cardium,  etc. ;  and  it  may  be  almost  impossible  to  discover  anything 
abnormal  in  the  cord,  for  although  the  clots  closing  the  arteries  and 
veins  are  infected,  they  are  neither  separated  from  the  walls  of  the 
vessels  nor  broken  up. 

On  the  surface  of  the  urachus,  at  the  base  of  the  bladder,  and  in 
the  depths  of  the  peritoneal  folds  supporting  the  allantoid  arteries 
(sometimes  also  the  hepatic  vein),  unequivocal  signs  of  local  ascending 
infection  may,  however,  almost  always  be  found,  together  with  intense 
injection  of  the  capillaries,  little  haemorrhagic  spots,  and  commencing 
formation  of  false  membranes,  etc. 

The  infection  extends  also  by  the  lymphatic  vessels  contained  in 
these  peritoneal  folds,  and  finally  attains  the  sublumbar  region. 

When    the    disease    develops    less    rapidly    the    peritoneal    cavity 


SEPTICEMIA    OF    NEW-BORN    ANIMALS.  409 

contains  a  certain  quantity  of  blood-stained  serosity,  as  do  the  pleurse 
and  pericardium,  whilst  vascular  engorgement  of  the  serous  mem- 
branes is  extremely  marked.  The  intestine  shows  traces  of  congestion 
and  inflammation  throughout  its  length,  and  its  contents  contain  the 
specific  organism  in  very  large  numbers. 

Finally,  in  the  chronic  forms,  the  serous  membranes  and  the  intestine 
seem  only  slightly  attacked,  possibly  because  the  lesions  have  undergone 
retrogressive  changes.  The  striking  features  are  the  secondary  lesions, 
such  as  those  of  pneumonia,  broncho-pneumonia,  pericarditis,  and  abscess 
formation  in  the  lung. 

Nocard  gives  the  following  description  of  the  lesions  found  during  his 
investigation  of  "white  scour"  of  calves  in  Ireland  {J^cterinariau,  April, 
190'2,  p.  171 ;  see  also  Prof.  Mettam's  paper,  Vdcvinanan,  June,  1902, 
p.  307)  :— "  The  lesions  found  on  autopsy  vary  according  to  whether  the 
evolution  of  the  disease  has  been  rapid  or  slow.  One  lesion,  however,  is 
never  absent — that  of  the  navel  and  the  navel  vessels.  In  all  the  calves 
attacked  we  found  a  large  umbilicus  with  hardened  coats  enclosing  a  clot 
easily  broken  down,  sometimes  soft  and  purulent.  In  every  case,  also, 
we  observed  blood  suffusions,  often  very  extensive,  along  the  course  of 
the  umbilical  vessels  and  of  the  urachus,  invading  often  the  posterior 
third  of  the  bladder.  In  cases  where  the  evolution  had  been  rapid  we 
found  the  lesions  of  true  haemorrhagic  septicaemia.  All  the  viscera  were 
congested  to  excess ;  their  surface  was  studded  with  petechia,  ecchy- 
moses,  or  subserous  blood  suffusions.  The  capillary  network  of  the 
peritoneum,  pleura,  and  pericardium  appeared  strongly  injected.  This 
lesion  was  especially  marked  on  the  epiploon.  The  intestine  was  the 
seat  of  intense  congestion,  especially  at  the  level  of  the  '  floating 
colon.' 

"  The  mucous  meml)rane  was  thickened,  gorged  with  blood,  and 
friable ;  the  solitary  glands,  thick  and  protruding,  were  sometimes 
transformed  into  a  kind  of  bloody  magma,  or  they  were  ulcerated,  as  in 
anthrax  ;  the  contents  of  the  bowel  were  mixed  with  a  large  quantity  of 
blood.  The  mucous  membrane  of  the  fourth  stomach  was  altered  nearly 
to  the  same  degree ;  it  was  studded  with  interstitial  haemorrhages,  espe- 
cially above  the  level  of  the  open  edge  of  its  folds.  The  mesenteric 
glands — especially  those  of  the  colon — were  enormous,  gorged  with  blood, 
reddish,  and  often  hfemorrhagic.  The  mucous  membrane  of  the  bladder 
was  often  covered  with  petechiae,  the  urine  which  it  contained  was  clear 
and  limpid,  but  always  rich  in  albumen.  [In  one  sample  which  was 
analysed,  the  urine  contained  more  than  4  grammes  of  albumen  to  the 
litre.]  The  lungs  were  gorged  with  blood,  like  the  intestines  ;  sometimes 
they  were  manifestly  cedematous,  but  generally  their  tissue  was  still 
supple,  elastic,  permeable,  and  without  apparent  lesion. 


410  DISEASES    OF    THE    BLOOD. 

"  In  the  su])acute  forms  the  lesions  are  much  less  marked.  The  mucous 
membrane  of  the  intestine  is  less  congested  ;  sometimes  oedema  of  the 
submucous  tissue  exists.  The  mucous  membrane  of  the  fourth  stomach 
is  often  punctuated  with  brownish-red  patches,  traces  of  the  capillary 
hfemorrhages  w'hich  were  produced  at  the  onset  of  the  disease.  The 
mesenteric  glands  are  swollen,  gorged  with  serum,  but  not  hfemor- 
rhagic ;  the  liver  is  large  and  of  a  yellowish  tint ;  the  spleen  is  little 
altered;  the  urine  always  contains  albumen;  the  lungs  are  seldom 
quite  sound ;  they  usually  contain  here  and  there  small  diffuse  centres 
of  catarrhal  pneumonia,  of  nodular  bronchial  pneumonia,  or  simply  of 
atelectasis. 

"These  lesions  are  more  constant  and  more  dense  if  the  animals 
have  resisted  the  disease  for  some  time ;  they  then  constitute  the 
transition  stage  between  the  simple  collapse  at  the  beginning  of  the 
disease  and  the  suppurating  lesion  of  lung  disease.  The  joint  lesions 
when  they  exist  are  very  interesting.  At  the  beginning  all  the  peri- 
articular tissues  are  infiltrated  with  a  yellowish  gelatinous  serosity. 
The  synovial  membrane  is  covered  with  vascular  aborisations  of  an 
extreme  richness,  which  extend  on  to  the  articular  cartilages.  The 
synovial  capsules  are  distended  by  a  considerable  quantity  of  thick 
synovia  of  a  deep  yellow  or  brownish  tint,  holding  in  suspension  flakes 
of  fibrous  exudate  more  or  less  dense  and  abundant.  When  the  lesion 
is  older  the  synovia  is  replaced  by  a  thick  fibrous  exudate,  which  fills 
sacculations,  and  extends  between  the  articular  surfaces.  In  this  case 
the  lesion  appears  identical  with  that  of  the  arthritis  seen  in  pleuro- 
pneumonia of  sucking  calves." 

Diagnosis.  The  diagnosis  presents  no  difficulty,  for  the  development 
and  acute  course  of  the  disease  (the  majority  of  patients  die  within  a 
week  of  birth)  leave  little  room  for  doubt. 

This  disease  is  easily  distinguished  from  dysentery  in  new-born 
animals,  which  appears  at  birth,  as  also  from  simple  diarrhoeic  ente- 
ritis; in  the  latter  disease  the  symptoms  are  delayed,  sometimes  occur- 
ring only  when  the  animals  are  weaned ;  moreover,  the  disease  is  never 
so  grave  as  that  now  under  consideration. 

Should,  however,  the  post-mortem  appearances  seem  indecisive,  the 
diagnosis  can  be  based  simply  on  the  high  mortality. 

Prognosis.  The  prognosis  is  extremely  grave.  About  95  per  cent, 
of  the  animals  attacked  die,  and  among  those  which  survive  many  show 
thoracic  complications,  that  render  them  useless. 

Treatment.  Treatment  of  animals  already  affected  is  useless,  and, 
moreover,  too  costly.  Drugs  administered  through  the  digestive  ap- 
paratus to  a  large  extent  miss  their  mark,  because  the  digestive  symp- 
toms   are  secondary,  primary  infection   having    occurred    through   the 


SEPTIC^-MIA    OF    NEW-BORN    ANIMALS. 


411 


circulation.     The  administration  of  purgatives  and  internal  antiseptics 
can,  therefore,  only  prove  illusory. 

On  the  other  hand,  prophylactic  treatment  is  of  the  greatest  value ; 
all  that  is  necessary  is  to  prevent  the  umbilical  cord  from  becoming 
infected. 

The  great  mortality,  which  causes  such  severe  loss  to  breeders,  is 
simply  due  to  want  of  proper  care  of  new-born  animals.  Even  in 
carefully  kept  byres  the  mortality  may  be  high,  for  the  specific  agent 
develops  in  litter  contaminated  with  faecal  matter,  by  lying  on  which 
young  animals  become  fatally  infected. 

To  check  or  prevent  this  septicaemia  in  breeding  establishments,  it  is 
merely  necessary  to  take  the  same  precaution  as  is  taken  in  dealing  with 
young  children,  i.e.,  to  apply  an  aseptic  or  antiseptic  dressing  to  the  stump 
of  the  cord  after  ligation.  As  soon  as  the  young  animal  has  been  dried 
by  the  mother  or  by  artificial 
means,  a  carefully  boiled 
ligature  is  applied  to  the 
cord  at  a  distance  of  about 
1  inch  from  the  umbilical 
ring.  The  portion  of  the 
cord  below  the  ligature  is 
snipped  off,  the  remaining 
part  is  carefully  washed  with 
boiled  water  or  boric  solu- 
tion, and  is  surrounded  with 
a  mass  of  iodoform  wool,  kept 
in  place  by  a  bandage  passed 
over  the  back. 

The  cord  will  shrivel  a 
little  less  rapidly  than  it 
would  if  exposed  to  the  air,  but  will  be  protected  from  all  infection. 
The  young  animal  should  be  separated  from  the  mother  to  prevent 
her  from  displacing  the  dressing  by  licking  the  parts. 

In  a  few  days  all  danger  is  at  an  end.  This  method  is  very 
simple,  and  can  be  carried  out  even  by  the  breeder  and  in  an  in- 
fected byre.  Nocard  recommends  the  use  of  umbilical  dressings  con- 
taining collodion,  and  the  practitioner  can  choose  whichever  method 
he  pleases. 

In  grave  outbreaks  involving  large  establishments,  the  byres  should 
be  rigorously  disinfected,  and  it  is  sometimes  well  to  segregate  cows 
about  to  calve  in  a  special  byre,  from  which  the  calves  are  not  allowed 
to  pass   until  the  umbilicus  is  cicatrised. 


Fig.  184. — Dressing  for  umbilicus  of  new- 
born calf. 


412  DISEASES    OF   THE    BLOOD. 


TAKOSIS:    A    CONTAGIOUS    DISEASE    OF    GOATS.* 

This  disease  has  heen  seen  in  Angora  goats  hronght  from  Texas  into 
Pennsylvania,  U.S.A. 

Symptoms.  The  disease  presents  many  of  the  symptoms  usually 
accompanying  a  parasitic  invasion,  and  is  characterised  by  great  emacia- 
tion and  weakness,  with  symptoms  of  diarrhcea  and  pneumonia.  In  the 
early  stages  of  the  affection  there  is  usually  little  to  indicate  that  any- 
thing is  seriously  amiss  with  the  animal.  The  first  observable  symptom 
manifested  is  the  listless  and  languid  appearance  of  the  animal,  evidenced 
by  its  lagging  behind  the  flock,  and  is  usually  accompanied  by  a  drooping 
of  the  ears  and  a  drowsy  appearance  of  the  eyes.  The  pulse  is  slow  and 
feeble,  and  the  temperature  is  elevated  slightly  at  first,  but  becomes  sub- 
normal a  few  days  before  death.  The  highest  temperature  observed  in 
the  natural  disease  was  104"1°,  and  the  lowest,  in  a  prostrated  animal  a 
few  hours  before  death,  registered  99*7°  Fahr.  Snuffling  of  the  nose,  as 
in  a  case  of  coryza,  with  occasional  coughing  is  sometimes  in  evidence. 

As  the  disease  advances  the  animal  moves  about  in  a  desultory 
manner,  with  back  arched,  neck  drawn  down  toward  the  sternum,  and 
with  a  staggering  gait.  Kumination  is  seldom  impaired.  The  appetite, 
while  not  so  vigorous,  is  still  present,  though  capricious,  and  the  affected 
animal  shows  plainly  that  the  ravages  of  the  disease  are  rapidly  over- 
coming the  restorative  elements  derived  from  the  food.  The  fleece  is 
usually  of  good  growth,  and  presents  a  surprisingly  thrifty  appearance 
when  the  condition  of  the  animal  is  taken  into  consideration.  All  the 
exposed  mucous  membranes  appear  pale,  and  the  respirations  are  accele- 
rated and  laboured.  The  goats  finally  become  so  weak  that  they  are 
readily  knocked  down  and  trampled  upon  by  their  fellows.  If  picked  up 
they  may  move  off  slowly  and  eat  a  little,  but  within  a  few  hours  are 
down  again,  and  in  this  way  linger  for  several  days,  shrinking  to  about 
half  their  natural  weight,  and  occasionally  bleating  or  groaning,  with 
head  bent  around  on  the  side  or  drawn  down  to  the  sternum.  A  fluid 
discharge  from  the  bowels  of  a  very  offensive  odour  is  usually  observed 
in  the  last  few  days  of  life,  but  this  symptom  is  not  constant. 

Course  and  Susceptibility.  This  disease  may  assume  a  subacute  or 
chronic  type,  usually  the  latter.  The  animal  dies  of  inanition  in  from 
eight  days  to  six  or  eight  weeks.  Several  owners  have  reported  deaths 
after  only  two  or  three  days  of  illness,  but  the  goats  doubtless  had  been 
affected  for  a  longer  period,  although  not  noticed  on  account  of  their 
mingling  in  the  flock.    Many  of  the  animals  live  for  weeks,  but  gradually 

*  Annual  Report,  U.S.A.  Bureau  of  Animal  Industry,  1902,  p.  854  (Mohler  and 
Washburn). 


TAKOSIS  :    A   CONTAGIOUS   DISEASE   OF   GOATS.  413 

become  weaker  and  more  debilitated,  finally  dying  in  a  comatose  condi- 
tion. In  no  instance  has  the  natural  recovery  of  an  animal  after  once 
the  symptoms  of  takosis  were  noticed  been  observed  or  heard  of. 

The  younger  goats  seem  to  be  the  most  susceptible  to  the  disease, 
although  the  old  animals  are  by  no  means  immune. 

Pathological  Anatomy.  As  already  indicated,  the  general  appearance 
of  the  carcase  simulates  that  produced  by  a  wasting  disease.  The  visible 
mucous  membranes  are  pale  and  anaemic,  while  the  fleece,  which  appears 
somewhat  dry  and  lustreless,  furnishes  a  shroud  for  the  extremely 
emaciated  condition,  that  becomes  plainly  perceptible  on  skinning.  The 
same  anaemic  condition  of  the  subcutaneous  and  muscular  tissues  is 
observed  on  eviscerating  the  carcases.  The  lungs  in  most  cases  are  the 
seat  of  a  peculiar  diversified  inflammation,  never  of  a  remarkable  extent. 
The  external  appearance  of  these  organs  is  at  times  mottled,  caused  by 
a  few  congested  areas,  several  patches  of  an  iron-grey  colour  similar  to 
areas  of  pneumonia  during  the  process  of  absorption,  and  normal  tissue. 
On  section  through  the  reddened  patches,  a  frothy  mucus  may  exude 
from  the  bronchioles,  and  in  one  case  numerous  punctiform  haemorrhages 
were  observed  on  the  sides  of  the  incision.  This  tissue,  while  not  so 
buoyant  as  a  normal  portion  would  be,  nevertheless  floats  when  placed 
in  water. 

The  heart  in  all  cases  is  pale  and  dull,  its  tissue  soft  and  flabby, 
while  inflamed  areas,  more  or  less  penetrating,  are  present  at  times  on 
the  epicardium  about  the  auricular  appendages,  and  at  other  times  on 
the  endocardium,  especially  that  lining  the  ventricles.  These  haemor- 
rhagic  patches  consist  of  either  pure  extravasated  blood  or  blood  mixed 
with  serum,  which  gives  them  a  more  diffuse  appearance  and  a  gela- 
tinous consistence.  The  pericardium  is  slightly  thickened,  and  usually 
contains  a  small  increase  of  fluid  tinged  with  blood.  The  liver  usually 
appears  normal,  although  the  gall  bladder  is  frequently  distended  with 
pale-yellow  watery  bile.  The  kidneys  are  anaemic  and  softened.  The 
cortex  appears  slightly  thicker  and  paler  than  normal,  and  contrasts 
strongly  with  the  darker  pyramids.  The  capsule  strips  oft"  easily  from 
the  parenchyma  of  the  organ.  In  one  instance  several  pale  areas  simu- 
lating anaemic  infarcts  were  observed  under  the  capsule  extending  into 
the  cortex,  which  probably  resulted  from  the  compression  of  the  capillaries 
by  the  swollen  parenchymatous  cells.  The  presence  of  albumin  in  the 
urine  was  detected  by  the  nitric-acid  test.  The  spleen  appears  atrophied 
and  indurated,  and  on  section  the  fibrous  tissue  far  exceeds  the  splenic 
pulp.  Attachments  by  fibrous  adhesions  may  fix  the  spleen  to  the 
diaphragm  or  the  neighbouring  organs.  The  intestines  may  contain 
normal  faecal  matter  or  semi-fluid  faeces  of  a  disagreeable  odour.  The 
surface   of   the   mucous   membrane   is    at   times  covered  with  a  slimy 


414  DISEASES   Ol'   THE    BLOOD. 

mucus  or  plastic  exudate,  and  the  appearance  is  that  of  a  chronic  catarrh 
associated  with  necrosis  of  the  mucosa. 

Bacteriology.  Examination  of  cultures  and  slides  showed  the  presence 
of  a  micrococcus,  usually  arranged  in  the  form  of  a  diplococcus,  which 
was  found  in  pure  cultures  from  the  heart's  blood,  spleen,  kidneys,  and 
pericardial  fluid,  and  essentially  so  in  the  tubes  inoculated  from  the 
other  organs. 

The  specific  organism  of  takosis  appears  in  fresh  bouillon  cultures  as 
a  spherical  or  oval  micrococcus  with  a  diameter  of  0"8  to  1  /a.  In  these 
cultures  it  is  single  or  in  chains  of  two,  three,  or  four  elements,  but  most 
frequently  in  pairs,  as  diplococci,  with  a  diameter  transverse  to  the  axis 
of  the  chain  greater  than  the  longitudinal  diameter. 

Treatment :  Prophylaxis.  Sudden  climatic  changes  should  be 
avoided  as  far  as  possible,  and  when  shipments  of  goats  for  breeding 
purposes  are  to  be  made  which  necessitate  their  transportation  over 
considerable  distances  the  changes  should  be  made  during  the  months 
of  summer  or  late  spring,  and  not  in  the  fall  or  winter,  when  the  con- 
trast of  temperature  will  be  so  much  greater. 

Angora  goats  should  be  provided  with  stables  that  are  thoroughly 
dry,  erected  upon  ground  that  has  perfect  natural  drainage. 

As  a  third  measure  of  prevention  may  be  mentioned  careful  feeding. 

The  segregation  or  isolation  of  all  affected  animals  as  soon  as  they 
evince  any  symptoms  of  the  disease  will  be  found  a  most  valuable  means 
of  protection  for  those  that  remain  unaffected,  and  a  strict  quarantine 
over  all  of  the  diseased  members  of  the  flock  should  be  maintained  so 
long  as  the  disease  remains  upon  the  premises. 

Medicinal  treatment  has  proved  unsatisfactory  in  many  of  the  cases 
of  takosis  to  which  it  has  been  applied.  The  best  results  have  been 
derived  from  the  administration  of  calomel  in  0.1 -gram  doses  twice  daily 
for  two  days,  followed  by  arsenic,  iron,  and  quinine,  as  follows : 

Arsenious  acid  .  .  .  .  .  .  .  .  .  .  .  .        1-40  grams. 

Iron,  reduced .  .  ..  ..  ..  ..  ..  ..      12-00         ,, 

Quinine  sulphate       .  .  .  .  .  .  .  .  .  .        6.00         ,, 

Mix  and  make  into  twenty  powders,  giving  one  to  each  adult  goat 
morning  and  evening  at  the  conclusion  of  the  administration  of  calomel. 
After  an  interval  of  two  days  this  treatment  is  repeated.  In  case  the 
diarrhoea  persists,  the  sulphate  of  iron  has  been  substituted  for  the 
reduced  iron,  with  beneficial  effects. 

Conclusions.  After  i)reliminary  investigation,  the  following  con- 
clusions have  been  reached  : — 

(1.)  The  disease  described  as  takosis  has  appeared  in  many  parts  of 
America,  but  particularly  in  the  Northern  States,  where  it  has  caused 
great  loss  to  many  breeders  of  Angora  goats. 


BLOOD   POISONING    IX    SHEEP   AND    LAMBS.  4l5 

(2.)  It  is  a  progressive,  debilitative,  contagious  disease,  characterised 
by  great  emaciation  and  weakness,  with  symptoms '  of  diarrhcea  and 
pneumonia,  and  causes  a  mortaUty  of  100  per  cent,  of  those  afi'ected 
and  from  30  to  85  per  cent,  of  the  whole  flock. 

(3.)  From  the  carcases  of  numerous  animals  that  have  succumbed  a 
new  organism.  Micrococcus  c(ipri)ius,  has  been  recovered  in  purity,  and 
is  presumably  the  etiological  factor. 

(4.)  This  micrococcus  possesses  pathogenic  proj^erties  for  goats, 
chickens,  rabbits,  guinea  pigs,  and  white  mice,  but  not  for  sheep,  dogs, 
or  rats. 

(5.)  Medicinal  treatment  was  attempted  with  varying  success,  while 
the  immunising  experiments  thus  far  conducted  (although  too  few  to 
permit  of  any  conclusive  statement  or  accurate  estimate  as  to  their 
protective  value)  have  shown  highly  encouraging  results.  When  accom- 
panied with  measures  of  isolation  and  disinfection,  the  treatment  may 
prove  of  great  assistance  in  the  suppression  and  eradication  of  the 
disease  in  an  infected  flock. 

BLOOD    POISONING    (MALIGNANT    CEDEMA)    IN    SHEEP    AND 
LAMBS     IN     NEW     ZEALAND. 

This  disease,  which  occurs  during  the  operations  of  shearing  sheep 
and  of  castrating  and  docking  lambs,  is  the  cause  of  considerable  loss 
annually  to  sheep  breeders  in  several  districts  of  New  Zealand.  In  1893 
J.  A.  Gilruth,  Chief  Veterinarian  for  New  Zealand,  issued  a  leaflet 
dealing  with  the  disease  and  the  preventive  measures  to  be  adopted. 
Generally  the  first  thing  that  draws  the  owner's  attention  seriously  to 
the  condition  of  his  flock  is  the  discovery,  in  from  thirty-six  to  forty- 
eight  hours  after  docking  or  shearing,  of  a  few  dead  sheep  lying  in 
various  parts  of  the  paddocks.  Next  morning  he  finds  a  few  more  dead, 
and  so  on  for  three  or  four  days,  when,  as  a  rule,  the  mortality  ceases. 

Symptoms.  In  the  early  stages  of  this  disease  the  animal  seems 
listless,  disinclined  to  move  about,  and,  if  the  sun  is  shining  strongly, 
prefers  to  lie  in  the  shade.  If  forced  to  move,  the  hind  legs  are  drawn 
forward  with  a  peculiar  stiff,  dragging  motion,  as  if  there  were  no  joints. 
There  are  slight  muscular  tremors  all  over  the  body,  which  become 
spasmodic  as  the  disease  progresses.  If  the  flock  be  driven  about  much, 
the  diseased  animal  soon  shows  signs  of  great  fatigue,  ultimately  dropping 
to  the  ground  thoroughly  exhausted.  The  breathing  is  fast  and  j)ainful, 
being  maintained  more  by  a  series  of  spasmodic  jerks  than  by  any 
regular  act.  The  pulse  is  quick  and  weak ;  the  temperature  is  very  high, 
registering  106°  to  108°  Fahr.,  showing  acute  fever;  the  eyes  close,  and 
the  whole  face  is  expressive  of  pain.  Gradually  the  spasms  cease  and 
coma  sets  in,  resulting  in  death.     The  scrotum  and  surrounding  skin 


416  DISEASES    OF    THK    BLOOD. 

right  along  the  floor  of  the  ahdomeii  and  het\Yeen  the  hind  legs  hecome 
swollen  and  hlack.  This  gangrenous  tissue,  when  present  hefore  death, 
can  be  peeled  oft'  without  pain  to  the  animal.  On  post-mortem  examina- 
tion various  conditions  are  met  with.  The  animals  are  generally  found 
to  he  among  the  best  of  the  flock  and  in  fairly  good  condition.  The 
scrotal  and  perineal  regions  in  lambs  (between  hind  legs  and  below 
tail)  are  always,  or  almost  always,  gangrenous,  this  condition  extending 
along  to  the  floor  of  the  chest,  and  sometimes  implicating  the  tail. 
Man}'  of  the  muscles,  generally  those  of  the  shoulders,  haunches,  and 
loins,  are  dark  in  colour  and  infiltrated  with  a  black,  watery  fluid.  The 
intestines  are  generally  healthy,  though  sometimes  the  peritoneum  is 
inflamed.  The  spleen  and  liver  are  in  the  usual  condition  after  death, 
due  to  febrile  disturbance.  In  the  chest,  either  the  pleurae  (coverings 
of  the  lungs)  or  pericardium  covering  of  the  heart)  are  often  inflamed, 
with  occasionally  a  fibrinous  exudation,  causing  surfaces  to  adhere. 

Cause.  In  (jilruth's  report  for  1900  he  demonstrated  the  cause  of 
blood-poisoning  to  be  a  microbe  known  as  the  malignant  oedema  bacillus 
{Vihriuu  Heptique  of  Pasteur).  This  organism,  which  is  found  in  many 
dirty  yards,  swampy  soils,  etc.,  on  gaining  entrance  to  the  system  of 
almost  any  animal  by  means  of  a  wound,  rapidly  increases  in  numbers, 
producing  gangrene,  or  death,  of  the  part  affected  first,  and  ultimately 
the  death  of  the  animal. 

Curative  treatment  is  practically  useless. 

Preventive  measures.  Destruction  of  the  carcases  of  animals  which 
have  succumbed  to  this  disease  by  efficient  burial  or  by  fire.  Disinfection 
of  surface  soil  of  yards,  etc.,  by  quick-lime.  Cleansing  of  floors  and  walls 
of  sheds  with  strong  hot  lime  wash  containing  crude  carbolic  acid  in  the 
proportion  of  1  to  50.  Disinfection  of  flesh  cuts  made  by  the  shears  or 
the  docking  or  castrating  knife.  Boiling  of  docking  and  tailing  knives 
before  use.  Observance  of  antiseptic  applications  even  w^hen  temporary 
yards  are  employed.  Sheep  and  lambs  after  operation  to  be  kept  in.  a 
paddock  free  from  swampy  patches. 

PIROPLASMOSIS. 
Under  the  title  piroplasmosis  is  included  a  group  of  diseases  caused 
by  lipemosporidia,  and  found  in  animals  of  the  bovine  and  ovine  species. 
These  affections  are  far  from  having  the  same  importance  in  temperate 
as  they  have  in  tropical  countries  ;  nevertheless,  it  is  very  important  to 
be  able  to  recognise  them. 

BOVINE    PIROPLASMOSIS. 

Bovine  piroplasmosis  has  been  described  under  different  names,  such 
as  haemoglobinsemia,  ha^moglobinuria,  Texas  fever   (U.S.A.),  tick  fever 


Fig.  187. — Angora  goat  (photographed  three  days  before  death). 
(Ann.  Eep.  U.S.A.  Bur.  An.  Ind.  1902.) 


Fig.  188. — The  same  goat  as  shown  in  Fig.  187.    Position  assumed  after  exhaustive 
efforts  to  regam  its  feet.     (Ann.  Rep.  U.S.A.  Bui'.  An.  Ind.  1902). 


Fig.  189.— Portion  of  a  steer's  hide,  showing  the  Texas  fever  tick  {Booj^JuIks 
annulatus)  of  the  United  States.  Natural  size.  (Styles,  Ann.  Hep.  Bur. 
An.  Ind.  1900.) 


Fig.  190. — Two  female  ticks  [Hyalomma  aTjijptiitm)  ovipositing. 
Natural  size.  (Photograph  by  J.  E.  Emery.  Annual  Report, 
U.S.A.  Bureau  of  Animal  Industry,  1900.) 


BOVINE   PIROPLASMOSIS. 


417 


(Australia),  tristeza  (Argentine  Republic),  African  coast  fever,  East 
Coast  fever,  redwater,  Rhodesian  fever  (Cape),  and  bovine  malaria. 

It  was  first  described  by  Babes  in  1888,  in  animals  inhabiting  the 
Danube  Valley,  and  was  termed  by  him  bacterial  hiemoglobinuria  of  the 
ox.  Afterwards  it  was  well  described  by  Smith  and  Kilborne  (in  1889) 
under  the  title  of  Texas  fever.  It  was  re-discovered  in  Finland  by 
Krogius  and  Van  Hellens  in  1894 ;  in  Sardinia  by  San  Felice  and 
Loi ;  in  Australia  in  1895  by  Pound ;  and  it  has  been  the  object  of  re- 
markable investigations  by  Koch  in  South  Africa  (1898-1904). 

Nicolle  and  Adil-Bey  (1899)  state  that  it  exists  in  a  latent  form  in 
European  Turkey  and  Asiatic  Turkey  ;   and  Lignieres    (1900),    after  a 


Fig.  191. — Dorsal  view  of  larva  of  BoojjJiilus  annulatus  of  North  America.     Greatl^^ 
enlarged.    (Stiles,  Ann.  Eep.,  U.S.A.  Bur.  An.  Ind.,  1900,  p.  388.) 

series  of  researches  in  Argentina,  suggests  the  final  solution  of  the 
questions  which  it  raises. 

Symptoms.  Babes  describes  it  as  an  acute  febrile  disease,  clinically 
distinguished  by  the  passage  of  blood-stained  urine.  The  urine  is 
coloured  by  dissolved  haemoglobin  ;  red  blood  corpuscles  are  not  found. 
Smith  and  Kilborne,  and  afterwards  Stiles,  described  two  forms :  an 
acute,  rapidly  fatal  form,  in  which  the  Piroplasma  higeminum  is  found 
in  the  blood  of  the  general  circulation,  in  the  spleen  and  kidneys  ;  and 
a  chronic  form,  in  which,  notwithstanding  the  absence  of  clinical  signs, 
the  parasites  may  be  discovered  in  the  blood  under  the  form  of 
diplococci. 

Lignieres  describes  a  grave  and  a  benignant  form.     The  grave  form 

D.C.  E  E 


418 


DISEASES    OF    THE    BLOOD. 


is  indicated  by  dulness,  loss  of  appetite,  and  considerable  fever.  In 
twenty-four  hours  the  temperature  rises  to  104°  or  105°  Fahr.,  and 
the  pulse  to  100  or  120  per  minute,  while  the  respiration  is  greatly 
accelerated. 

The  urine  is  of  a  light-red  or  brownish-red  colour,  resembling 
coffee-grounds,  but  it  contains  no  blood  corpuscles.  The  animals  die 
in  frora  three  to  eight  days  with  symptoms  of  asphyxia ;  but  this 
termination  is  not  inevitable,  and  recovery  may  occur  spontaneously. 
Improvement  is  indicated   by  a  fall  in  temperature,   disappearance  of 


Fig.  192. — Ventral  view  of  larva  of  Boojjhilus  annularis  of  North  America.     Greatlj' 
enlarged.    (Stiles,  Ann.  Rep.,  U.S.A.  Bur.  An.  Ind.,  1900,  p.  388.) 

the  blood-stained  urine,  and  a  return  of  appetite,  together  with  marked 
thirst. 

Drs.  Smith  and  Kilborne  describe  the  symptoms  as  follows : — "  The 
beast  when  first  observed  to  be  amiss  appears  to  be  dull  and  sluggish, 
with  a  disinclination  to  move,  and  hence  it  is  generally  found  apart 
from  the  rest  of  the  herd.  The  hair  stands  erect  like  that  of  an  animal 
on  a  cold  day  (a  staring  coat),  the  ears  hang,  and  the  eyes  have  a  dull 
and  lustreless  appearance.  In  some  cases  the  animals  cease  to  feed, 
or  ruminate,  in  others  they  continue  to  nibble  at  the  herbage  until 
nearly  the  last,  but  in  a  languid,  indifferent  manner,  indicating  that 
they  have  little  relish  for  their  food,  and  they  fall. off  very  rapidly  in 
condition.  There  is  generally  a  dribbling  of  saliva  from  the  mouth, 
the  muzzle  may  appear  quite  moist  during  the  early  stages  of  the 
disease,    but   it   invariably    becomes    dry    and    crusty   as    the   disease 


BOVINE    PIROPLASMOSIS. 


419 


advances.  Later  on  the  animal  manifests  a  strong  reluctance  to  move, 
and  Avhen  compelled  to  do  so,  it  walks  with  a  dragging,  straddling 
gait,  as  if  weak  across  the  loins.  In  severe  cases,  when  the  sick 
heast  is  left  undisturbed,  it  will  remain  almost  constantly  in  one 
place,  standing  with  its  head  depressed  and  ears  hanging  in  a  drowsy 
semi-comatose  condition,  looking  the  very  picture  of  complete  nervous 
prostration.  Other  animals  will  lie  down  the  greater  part  of  the  time 
and  scarcely  move,  and  when 
dead  the  limbs  will  be  found 
in  their  natural  position,  and 
the  head  doubled  round  on 
the  shoulder  as  .if  asleep.  On 
making  a  post  -  mortem  ex- 
amination of  some  of  these 
cases  the  carcase  was  found 
to  be  pale  and  bloodless,  as 
if  the  animal  had  been  bled 
to  death. 

•  "In  other  acute  cases  a 
twitching  and  quivering  of 
the  muscles  will  be  observed, 
especially  of  those  situated 
in  the  flank  and  behind 
the  shoulder.  The  pulse 
and  breathing  are  much 
quickened,  and  the  animal 
will  stand  and  grind  its  teeth 
and  curl  up  its  upper  lip, 
indicating  great  uneasiness 
and  pain.  The  ffeces  during 
the  early  stages  of  the  disease 
are  very  often  soft,  with  a 
tendency  to  diarrhoea,  more 
especially  in   transport   oxen 

on  the  road,  but  they  invariably  become  hard  as  the  disease  advances ; 
but  whether  hard  or  soft,  they  have  generally  a  brownish  tinge,  and 
often  mixed  more  or  less  with  blood  and  mucus.  In  some  severe  cases 
which  recover,  the  favourable  crisis  is  often  ushered  in  by  a  salutary 
diarrhoea." 

In  the  benign  form  the  animal  for  the  space  of  about  a  week 
shows  indifference  to  its  surroundings,  loses  its  appetite,  wastes,  and, 
less  frequently,  has  slight  feverish  symptoms,  without  discoloration 
of    the     urine.       The   only    reason    for    the   belief    that    this   trifling 

E  E  2 


Fig.  193.— Scutum  and  scutellum  of  female 
Boophiliis  annulatus,  showing  mouth  parts, 
porose  areas  i}}-  (t.),  and  eyes  (e).  Greatly 
jiiagnitied.  (Stiles,  Ann.  Eep.,  U.S.A.  Bur. 
An.  Ind.,  1900,  p.  392.) 


420 


DISEASES    OF    THE    BLOOD. 


disturbance  is  due  to  piroplasmosis  is  furnished  by  examination  of  the 
blood,  in  which  the  parasites  may  be  found  in  very  small  numbers  in 
certain  blood  corpuscles. 

Calves  seldom  take  the  disease  except  in  the  benign  form. 


Fig,  194. — A,  red  blood  corpuscles  containing  pear-shaped  Piroplasma  higeminum 
(the  typical  form) ;  B,  red  blood  corpuscles  containing  round  Pii-oplasma  bige- 
viinum.     (After  Lignieres.) 

Lesions.     At  first  glance  the   lesions  appear   to  resemble  those  of 
anthrax,  but  may  be  differentiated  from  them  in  many  details. 

The  skin  is  covered  with  ticks  or  shows  traces  of  their  punctures. 


Fig.  19;-). 


The  myocardium  appears  as  if  boiled,  the  spleen  is  invariably 
hypertrophied  and  two  or  three  times  as  large  as  in  the  normal  state. 

The  kidneys  are  violet  in  colour  and  congested,  and  the  adipose 
layer  surrounding  the  kidney  is  infiltrated  with  a  yellowish  serosity. 


BOVINE   PIROPLASMOSIS,  421 

The  urine  may  present  a  variety  of  tints,  derived  from  hajmogiobin. 
The  Kver  is  often  engorged  with  blood  and  the  gall  bladder  always 
distended. 

When  convalescence  sets  in,  icteius  appears ;  but  it  is  a  special 
kind  of  icterus,  depending  on  changes  in  the  haemoglobin — in  fact,  a 
haemaphseic  icterus.  Histological  examination  of  the  blood  furnishes 
the  explanation  of  the  disease  by  revealing  the  presence  of  the  parasite. 


■.J 


^ 


Fig.  196. — Slow  formation  of  free  germs.  1,  Pear-shaped  organisms  \\ith  large  chro- 
matic element  and  a  flagellum;  2,  newly-developed  round  cell  without  chromatic 
element ;  3,  4  and  5,  formation  of  the  chromatic  elements  ;  6,  the  germs  about  to 
escape  ;  7,  the  germs  freed.     (After  Lignieres.) 

Pathogeny.  The  parasite  is  the  Piroplasnta  hitioninum,  which  is 
easily  demonstrated  by  drying  the  blood,  fixing  it  and  staining  with 
very  weak  methylene  blue.  The  blood  is  light  in  colour  and  pale, 
and  the  serum   is  tinted   by   the  dissolved    haemoglobin.       The   blood 


Fig.  197. — Kapid  formation  of  free  germs.  1,  Newly-developed  round  parasite  without 
distinct  germs  ;  2,  round  parasite  with  two  germs  ;  3,  the  germs  approaching  the 
surface  and  undergoing  development ;  4,  the  germs  beginning  to  grow  outwards 
preparatory  to  forming  new  round  parasites  ;  5,  the  process  previously  noted  is 
becoming  more  marked  ;  the  protoplasm  of  the  cell  is  undergoing  degeneration, 
and  scarcely  stains  at  all  ;  6,  round  parasites.  This  completes  the  cycle.  These 
parasites  (6)  are  similar  to  (1).     (After  Lignieres.) 

corpuscles  diminish  in  number  with  extreme  rapidity  while  the  para- 
sites are  developing,  and  in  twenty-four  or  forty-eight  hours  may  fall 
from  some  six  millions  and  a  half,  the  normal  number,  to  one  million 
or  even  to  two  or  three  hundred  thousand  red  blood  corpuscles  per 
cubic  millimetre. 

This  destruction  is  due  to  the  action  of  the  piroplasmata,  as  may 
be  sliown  by  staining  with  a  "5  per  cent,  methylene  blue  or  carholised 
thionine.  These  parasites  usually  assume  a  simple  pyriform  shape, 
and  two  or  three  may  be  found  in  one  blood  corpuscle.     The  number 


422  DISEASES   OF   THE   BLOOD. 

of  parasites  and  infected  blood  corpuscles  is  generally  in  direct  ratio 
to  the  intensity  of  the  infection.  These  parasites  are  found  through- 
out the  blood,  but  principally  in  that  of  the  spleen,  kidneys,  and 
mesenteric  veins.  They  are  only  abundant  whilst  the  temperature  is 
rising  or  at  the  moment  when  it  reaches  its  highest  point,  and  they 
often  disappear  before  death  or  convalescence. 

The  pyriform  shape  is  only  temporary,  and  corresponds  to  the  acute 
phase  of  the  disease,  but  the  parasite  assumes  the  round  form  as  soon 
as  convalescence  sets  in.  This  round  form  gives  birth  to  one,  two  or 
three  spherical  spores,  which  are  set  free  in  the  plasma  after  the 
destruction  of  the  maternal  protoplasm,  and  are  able  after  trans- 
ference to  a  fresh  red  blood  corpuscle  to  again  assume  the  pyriform 
shape  peculiar  to  the  grave  forms  of  disease. 

The  parasite  can  only  be  cultivated  in  defibrinated  blood  from  a 
haemoglobinuric  subject,  and  the  cultures  do  not  always  yield  more 
than  reproductions  of  the  round  form,  the  pear-shaped  form  only 
being  produced  with  red  blood  corpuscles  in   the  living  animal  body. 

Regarding  the  method  of  growth  of  the  piroplasma  in  the  body  and 
in  cultures,  Lignieres  believes  that  the  parasite  may  produce  two  forms 
of  spores  differing  in  their  nature.  One,  the  active  spore,  has  little 
resisting  power.  It  soon  degenerates  outside  the  animal  body,  forms 
rapidly  at  the  expense  of  one  of  the  pear-shaped  parasites,  and  may 
immediately  reinfect  another  red  blood  corpuscle.  The  other,  called 
the  passive  spore,  is  very  resistant,  and  retains  its  vitality  for  a  long 
time  outside  the  body,  being  produced  at  the  expense  of  spherical 
parasites  already  withdrawn  and  incapable  of  producing  the  disease. 

The  form  of  piroplasmosis  at  present  under  consideration  is  peculiar 
to  the  ox,  and  none  of  the  other  domestic  animals  or  experimental 
subjects  can  be  inoculated  with  it. 

Subcutaneous  or  intravenous  inoculation  of  the  ox  with  5  to  10 
cubic  centimetres  always  gives  positive  results  when  made  with  blood 
or  active  products,  such  as  the  pear-shaped  parasites  or  active  spores, 
but  is  ineffectual  when  the  parasites  have  already  begun  to  retract 
in  order  to  form  passive  spores. 

Calves  i-eldom  contract  more  than  the  benign  form  of  the  disease, 
and  do  not  die. 

In  the  grave  form  following  experimental  infection  the  temperature 
begins  to  rise  between  the  third  and  sixth  day,  and  corresponds  with 
a  marked  increase  in  the  number  of  parasites  to  be  found  within  the 
red  blood  corpuscles.  The  urine  at  first  becomes  albuminous,  then 
htemoglobinuric,  whilst  the  red  blood  corpuscles  diminish  in  number 
to  a  very  marked  extent,  falling  from  about  six  or  seven  millions  to 
one  million,  or  even  a  tew  hundred  thousands,  in  the  course  of  a  few 


BOVINE    PIROPLASMOSIS.  423 

days.      The  temperature,   which  may   previously  have   risen  to  above 
105°  Fahr.,  suddenly  falls,  indicating  the  approach  of  death. 

If  an  immediate  autopsy  is  made,  the  spleen  is  always  found  to 
be  enlarged,  the  intestinal  mucous  membrane  reddish  in  tint  or  blood- 
stained, and  the  serous  membranes,  particularly  the  endocardium, 
covered  with  petechi^e. 

Few  or  no  parasites  can  be  discovered  except  in  the  blood  from 
the  cardiac  muscle  and  the  kidneys. 

The  grave  form  may  end  in  recovery.  This  end  is  indicated  by 
the  temperature  remaining  normal  after  defervescence,  the  ai^pearance 
of  hsemapliffiic  icterus  of  an.  obstinate  character,  and  the  progressive 
return  of  appetite. 

The  disease  is  usually  transmitted  by  adult  and  larval  ticks  carrying 
the  parasite  from  infected  animals.  Lignieres  has  proved  that  this 
transmission  occurs  through  the  medium  of  passive  spores,  which, 
though  themselves  incapable  of  producing  the  disease,  become  active 
and  infective  in  consequence  of  the  local  irritation  produced  by  the 
poisonous  saliva  of  the  ticks. 

The  pathogeny  of  Texas  fever  may  be  shortly  summed  up  as 
follows  : — Animals  suffering  from  the  disease  carry  in  their  blood  a 
protozoan  organism  called  the  Piroplasnia  bigoniniun,  analogous  to  the 
parasite  of  human  malaria ;  once  introduced  into  the  blood,  this 
organism  remains  there  in  an  active  condition  throughout  the  animal's 
life  ;  it  is  transferred  to  susceptible  cattle  either  within  or  without  the 
infected  district  by  the  Southern  (U.S.)  cattle  tick  Boophilus  annidatus ; 
Southern  cattle,  although  carrying  the  protozoa,  are  harmless  unless 
infested  by  this  particular  tick :  the  mature  ticks  and  their  eggs  con- 
tain the  protozoa,  and  the  mystery  of  certain  grounds  over  which 
infected  animals  have  passed  being  first  dangerous,  then  harmless, 
and  again  dangerous  depends  on — (a)  the  infestation  of  the  ground 
with  mature  infected  ticks ;  {h)  the  destruction  or.  death  of  the  mature 
ticks  ;  and  (c)  the  hatching  out  of  new  (infected)  ticks  from  the  eggs 
laid  on  the  ground  l)y  the  mature  female  ticks. 

Dr.  Salmon  states  that  in  Texas  a  successful  method  of  protection 
is  in  practice  based  on  the  observations  that  young  cattle  do  not 
suffer  so  severely  as  adults,  and  that  the  disease  always  assumes  a 
milder  form  in  winter.  Young  animals  introduced  during  the  winter 
are  inoculated  with  virulent  blood.  They  contract  a  mild  form  of 
disease,  and  afterwards  resist.  In  this  way  the  losses,  which  previously 
amounted  to  90  per  cent,  of  all  freshly  introduced  stock,  have  been 
reduced  to  about   10  per  cent. 

A  remarkable  and  very  interesting  observation  (if  absolutely  reliable) 
deserves  to  be  mentioned,  viz.,  that  the  ticks  develop  regularly  in  the 


424  DISEASES   OF   THE   BLOOD. 

natural  prairie,  but  do  not  develop  in  parts  artificially  sown  with  grass 
such  as  lucerne,  and  that  when  contaminated  or  diseased  animals  are 
transferred  to  artificial  meadows  they  do  not  convey  the  disease  to 
other  animals  already  there  ;  the  latter  are  proof   against  it. 

Diagnosis.  The  disease  is  so  typical  that  it  cannot  be  mistaken  for 
anthrax.  In  anthrax  the  urine  is  never  haemoglobinuric  and  very  rarely 
hsematuric,  and  the  faeces  are  sometimes  blood-stained,  a  symptom  never 
present  in  piroplasmosis.  Anthrax  can  be  transmitted  to  experimental 
animals,  but  piroplasmosis  cannot. 

Prognosis.     The  prognosis  is  generally  grave. 

Treatment.  Van  Hellens  recommends  the  use  of  quinine  in  large 
doses.  He  give  5  drachms  in  one  dose,  and  repeats  it  for  the  next  two, 
three,  or  four  days. 

Lignieres  says  that  he  has  never  obtained  the  slightest  success 
with  quinine,  though  it  is  true  he  has  never  given  higher  doses  than 
2^  drachms. 

Attempts  have  been  made  to  confer  immunity  by  injecting  animals 
with  serum  from  others  which  have  recovered.  Vaccination  with  the 
blood  of  patients  arrived  at  the  period  of  convalescence  has  also  been 
tried.     The  results,  however,  have  not  been  very  satisfactory. 

Lignieres  has  formulated  an  efiicient  method  of  vaccination,  of  which 
he  has  not  yet  published  the  full  details,  but  which  appeared  by  reason 
of  its  simplicity  likely  to  render  great  service.  Nevertheless,  his  most 
recent  reports  seem  to  show  that  vaccination  is  not  always  eflicacious, 
and  that  in  the  Argentine  Republic  alone  several  varieties  of  the  disease 
exist,  two  being  caused  by  allied  but  different  parasites.  The  vaccine 
used  against  one  variety  is  powerless  against  the  other.  The  problem  of 
vaccination  would  therefore  appear  to  be  much  more  complex  than  in 
the  case  where  one  form  only  occurs  in  any  particular  country. 

The  immunity  arising  from  attacks  of  piroplasmosis  is  in  direct  ratio 
to  the  gravity  of  the  disease,  and  according  to  Lignieres'  views  this 
acquired  immunity  is  due  to  the  secretion  by  the  piroplasma  of  a  sub- 
stance which  is  toxic  for  the  red  blood  corpuscles.  This  toxic  substance 
provokes,  as  in  other  diseases,  an  organic  antitoxic  reaction. 

BOVINE    PIROPLASMOSIS    IN    FRANCE. 

Until  recent  years  it  did  not  seem  that  piroplasmosis  occurred  in 
France.  It  had  been  detected  in  Algeria,  although  its  existence  had  not 
been  conclusively  proved.  Mathis  claims  to  have  met  with  it  in  the 
department  of  the  Loire  in  1896  and  in  the  Ain  in  consequence  of 
the  importation  of  Algerian  cattle,  but  its  ravages  were  comparatively 
triflinn-. 


BOVINE   PIROPLASMOSIS.  425 

Having  good  reason  to  suspect  that  certain  morbid  conditions,  known 
as  mal  de  Brou,  might  be  due  to  piroplasmosis,  Lignieres  endeavoured 
to  verify  his  theory,  and  discovered  that  sometimes,  but  not  often,  this 
disease  was  mistaken  in  France  for  anthrax  and  mal  de  Brou.  Piro- 
plasmosis in  France  appears  less  grave  than  in  America,  and  is  rarely 
fatal 

As  regards  its  symptoms,  it  usually  develops  suddenly  with  fever, 
loss  of  appetite,  acceleration  of  the  pulse  and  respiratory  movements, 
suppression  of  the  milk  secretion,  and  the  passage  of  red  haemoglobin- 
uric  urine.  In  exceptional  cases  death  may  occur  in  from  three  to 
five  days. 

On  post-mortem  examination  a  varying  number  of  ticks  {Ixodes 
Jiexagonus)  are  found  on  the  skin,  the  spleen  is  always  increased  in 
size,  and  the  kidneys  are  black  and  hgemorrhagic. 

The  disease  transmitted  by  ticks,  as  in  Texas  fever,  seems  due  to 
the  presence  of  a  round  parasite,  different  from  the  well-known  Piro- 
plasma  higeminum. 

The  elucidation  of  this  disease,  which  occurs  towards  the  northern 
frontier  of  France  in  the  neighbourhood  of  Maubeuge,  calls  for  further 
investigation.  It  never  appears  to  be  very  fatal,  and  it  attacks  more 
especially  animals  imported  into  the  infected  region.  A  method  of 
vaccination  identical  with  that  used  by  Lignieres  against  one  of  the 
forms  of  the  American  disease  may  perhaps  in  the  future  prove  avail- 
able against  the  disease  in  France.  Until  then  the  best  treatment 
would  appear  to  consist  in  free  subcutaneous  injection  of  saline  solu- 
tion and  the  administration  of  evacuants,  sulphate  of  quinine,  and 
laxatives. 

OVINE    PIROPLASMOSIS. 

Causation.  The  existence  in  France  of  this  disease  has  not  yet  been 
clearly  established,  for  in  the  only  communication  on  the  subject  (by 
Leblanc  in  1899)  the  writer  seems  to  have  confused  the  toxic  hsemo- 
globinuria  produced  by  feeding  on  decomposed  beet  pulp  with  the 
parasitic  hemoglobinuria  due  to  piroplasmosis. 

In  Italy  ovine  piroplasmosis  was  described  by  Bonomo  in  1896  under 
the  title  of  parasitic  icteric  hfematuria  of  sheep.  It  is  said  to  be  due  to 
a  parasite  of  the  red  blood  corpuscles  {Amo'ha  sporidium  polyphagum), 
the  said  parasite  being  of  oval  form,  very  refractile,  always  occupying 
an  outer  position  near  the  free  margin  of  the  corpuscle,  and  sometimes 
floating  freely  in  the  plasma. 

According  to  Babes,  who  described  it  under  the  name  of  garceac  du 
mouton,  the  same  disease  appears  to  occur  in  the  islands  and  low  parts 
of  the  Danube  valley. 


426  DISEASES    OF   THE    BLOOD. 

Symptoms.  The  development  of  this  parasite  produces  in  the 
patient  loss  of  appetite  and  high  fever,  accompanied  by  the  passage 
of  dark  coloured  lifemoglobinuric  urine.  Icterus  is  frequently  present. 
The  animals  rapidly  become  exhausted,  collapse  and  die. 

On  post-mortem  examination  carried  out  immediately  after  death 
the  spleen  is  found .  to  be  large,  the  pulp  being  like  wine  lees.  The 
liver  is  soft  and  yellowish  ;  the  kidneys  are  soft  and  black. 

The  disease  is  said  not  to  be  transmissible  by  direct  trans- 
fusion ('?). 

It  would  appear  that  this  disease  has  also  been  seen  in  Turkey  by 
Nicolle  and  Laveran,  near  Constantinople,  in  1899.  The  parasites  {Piro- 
plasma  oris)  are  round  or  slightly  elongated  and  occur  near  the  peri- 
phery of  the  red  blood  corpuscles.  It  is  to  be  hoped  in  the  interest  of 
breeders  in  localities  where  this  disease  rages  that  Lignieres'  method  of 
vaccination  aj^ainst  bovine  piroplasmosis  may  prove  reliable  and  equally 
applicable  in  the  case  of  sheep. 

DISEASES    PRODUCED    BY    TRYPANOSOMATA.* 

In  1904  Professor  Koch  delivered  an  address,  from  which  the  following 
is  a  summary,  to  the  Berlin  Medical  Society  regarding  his  experiences 
and  observations  on  diseases  produced  by  trypanosomata  in  Africa : — 

A  wide  field  of  study  has  recently  been  opened  by  the  discovery  of 
various  pathological  protozoa.  Three  discoveries  especially  have  directed 
attention  to  these  special  disease  organisms— 

(1.)  Laveran's  discoveries  regarding  malaria.  Eoss  has  shown  that 
the  malaria  parasites  are  carried  by  mosquitoes  {Anopheles  daviger). 

(2.)  The  discovery  of  the  protozoa  of  Texas  fever  by  Smith.  In  this 
case  ticks  {lilujjicepJialas  {hoophilus)  anmdatus)  convey  the  disease. 

(3.)  The  discovery  of  the  trypanosoma  of  the  tsetse  disease,  which  is 
conveyed  by  a  stinging  fly  {Glosshia  morsitans). 

These  discoveries  were  followed  by  numerous  others  indicating  pro- 
tozoa as  causes  of  disease. 

The  trypanosomata  are  morphologically  distinguished  by  the  existence 
of  a  flagellum.  When  fresh  blood  is  examined  it  is  scarcely  possible  to 
overlook  the  protozoa  in  the  preparation,  for  attention  is  at  once  attracted 
by  the  energetic  way  in  which  the  red  blood  corpuscles  are  continually 
being  displaced.  The  peculiar  form  of  the  protozoa,  however,  can  only 
be  detected  in  stained  preparations.     Eomanowsky's  staining  method  is 

*  An  interesting  article  and  a  series  of  figures  on  the  "  Evolution  of  the 
Trypanosoma  Evansi  "  were  published  in  the  Jour,  of  Comp.  Path,  and  Therap. 
for  September,  1904,  p.  210.  The  same  number  also  contained  articles  on  several 
piroplasmic  diseases. 


DISEASES   PRODUCED   BY   TRYPANOSOMATA.  427 

probabl}'  the  best.  Trypanosomata  stained  by  this  method  show  a  fish- 
shaped  body,  the  front  end  of  which  carries  a  flagellum.  The  body  of 
the  trypanosoma  is  coloured  blue.  At  the  anterior  end  may  be  seen  a 
red- stained  nucleus ;  at  the  opposite  end  a  much  smaller  red  spot,  which 
has  been  termed  the  nucleolus,  but  is  more  properly  described  as  the 
centrosome.  From  the  centrosome  a  red  thread  extends  along  the  outer 
margin  of  the  body  as  far  as  the  front  extremity,  where  it  becomes 
continuous  with  the  flagellum. 

The  trypanosomata  increase  by  longitudinal  fission.  The  centrosome 
and  then  the  nucleus  divide,  and  finally  a  second  flagellum  is  formed. 
Sometimes  the  young  trypanosomata  remain  connected,  producing  the 
so-called  "  rosettes." 

The  disturbance  produced  by  trypanosomata  seldom  becomes  acute, 
but  often  continues  for  years.  The  only  sign  of  disease  consists  in  ill- 
defined  fever  with  long  intermissions.  The  destruction  of  the  red  blood 
corpuscles  causes  anemia,  the  animals  or  men  become  weak  and  waste 
away,  oedema  and  sometimes  erythema  occur  at  varying  points  in  the 
body,  and  occasionally  the  lymphatic  glands  become  swollen. 

The  classical  land  of  the  tsetse  disease  is  in  the  neighbourhood  of  the 
Zambesi.  There  it  was  seen  and  very  well  described  by  Livingstone ; 
but,  unfortunately,  further  investigations  have  shown  that  tsetse  disease 
extends  over  the  whole  of  Africa. 

Whilst  the  trypanosomata  of  rats  can  only  be  conveyed  to  the  one 
species,  those  of  tsetse  disease  thrive  in  all  mammals,  particularly  in  the 
horse,  mule,  ox,  dog,  rat,  and  mouse. 

The  tsetse  organism  has  been  shown  to  kill  both  horses  and  mules, 
but  to  be  less  dangerous  for  oxen.  A  certain  relative  immunity  exists  in 
some  races.  As  regards  the  ass,  observers  are  not  agreed ;  Koch  failed 
to  infect  it.  Sheep  and  goats  are  also  but  slightly  susceptible.  The 
conveyance  of  trypanosomata  from  the  blood  to  uninfected  animals 
occurs  through  the  medium  of  a  stinging  fly  (the  Glossina  morsitans) . 

Surra  is  endemic  in  the  Philippines,  Java,  and  the  island  of  Mauritius. 
Koch  regards  the  trypanosomata  of  surra  as  strictly  analogous  with  the 
parasites  of  tsetse  disease.  Horses  (and,  in  India,  elephants)  especially 
sufi'er  from  surra.  Although  the  Glossina  morsitans  does  not  occur  in 
India,  other  stinging  flies  replace  it  and  convey  the  disease. 

Another  variety  of  trypanosomiasis  is  mal  de  caderas,  seen  in 
South  America,  particularly  in  Argentina  and  Brazil.  It  aft'ects  horses. 
According  to  Koch,  the  parasites  of  mal  de  caderas  exactly  resemble 
the  tsetse  and  surra  parasites.  Other  observers,  however,  declare  that 
the  mal  de  caderas  parasites  are  distinguished  from  those  before  men- 
tioned by  their  particularly  small  centrosome.  Mal  de  caderas  affects 
not  only  horses,  but  all  the  other  animals  which  suffer  from  tsetse. 


428  DISEASES   OF   THE    BLOOD. 

Another  variety  of  trypanosoma,  the  trypanosoma  Theileri,  is  espe- 
cially striking  on  account  of  its  size.  It  is  only  found  in  oxen,  and 
exhibits  a  very  slight  degree  of  virulence. 

Koch  divides  trypanosomata  into  two  great  groups. 

The  grouping  is  based  on  three  important  peculiarities  :  firstly,  the 
morphology  of  the  parasite  ;  secondly,  its  virulence  ;  and,  thirdly,  its 
relation  to  the  host. 

The  first  group  only  exists  in  one  species  of  animal.  They  have 
become  so  completely  accustomed  to  this  method  of  life  that  they  can- 
not exist  under  other  circumstances.  Their  virulence  is  slight  but  con- 
stant. This  group  comprises  the  trypanosoma  of  rats  and  the  try- 
panosoma Theileri. 

The  second  group  (to  which  all  other  trypanosomata  belong)  shows 
great  variation  in  virulence  and  in  form.  These  trypanosomata  are  not 
peculiar  to  any  one  species,  but  may  affect  dogs,  rats,  horses,  etc.  Their 
morphological  peculiarities  also  vary  according  to  the  animals  in  which 
they  are  found.  Thus,  the  tsetse  parasites  when  cultivated  in  the  bodies 
of  dogs  and  rats  become  much  smaller  than  usual,  and  the  centrosome 
appears  near  the  end ;  when  cultivated  in  horses  the  end  appears 
pointed,  and  the  centrosome  lies  near  the  centre  ;  in  the  pig  the  para- 
sites lose  their  peculiar  short  flagellum.  Their  virulence  also  varies 
within  wide  limits. 

It  has  been  found  possible,  as  in  the  case  of  bacteria,  to  modify  the 
virulence  of  trypanosomata  by  successive  passages  through  difierent 
animals.  By  inoculating  dogs  with  comparatively  innocuous  trypano- 
somata and  conveying  the  disease  from  dog  to  dog  the  virulence  is 
markedly  increased.  On  the  other  hand,  parasites  which  prove  ver}^ 
virulent  for  oxen  become  much  less  active  for  these  animals  after  pas- 
sages through  rats  and  dogs.  This  apparently  trifling  discovery  laid  the 
foundation  for  protective  inoculation  experiments.  Parasites  of  the 
second  group  can  also  exist  in  the  bodies  of  almost  all  mammals. 

Koch  is  of  opinion  that  the  parasites  of  surra  in  India  and  of  tsetse 
disease  in  Africa  are  absolutely  identical.  Laveran,  on  the  other  hand, 
states  that  he  has  protected  animals  against  tsetse,  and  that  they  have 
nevertheless  suffered  from  surra. 

That  this  in  no  way  disproves  the  identity  of  the  two  parasites  is 
shown  by  other  experiments. 

Koch,  whilst  in  Dar-es-Salaam,  made  some  interesting  experiments 
for  the  purpose  of  discovering  a  method  of  protective  inoculation.  He 
had  found  that  the  virulence  of  the  ox  parasites  could  be  modified.  He 
therefore  inoculated  oxen  first  with  these  weakened  parasites  and  after- 
wards with  others  of  high  virulence.  All  the  control  animals  died  while 
those  treated  as  above  remained  alive. 


LOUPING-ILL.  429 

Veterinary  Surgeon  Schmidt  kept  these  animals  under  observation, 
and  reinoculated  them  from  time  to  time  with  highly  virulent  material, 
notwithstanding  which  they  were  still  perfectly  well  six  years  after  the 
first  inoculation. 

In  practising  this  method,  hoAvever,  the  trypanosomata  used  for  the 
first  inoculation  must  not  be  unduly  weakened.  The  method  would  have 
appeared  fully  successful  were  it  not  for  the  fact  that  the  protected  and 
apparently  quite  vigorous  animals  still  suffered  from  the  presence  of 
parasites  in  the  blood.  To  extend  its  use,  therefore,  meant  that  one 
would  not  suppress,  but  would  spread  the  disease.  The  effect  would 
be  to  produce  herds  harbouring  the  parasite,  which  herds,  though 
exhibiting  no  signs  of  illness,  would  nevertheless  in  a  sense  be  propa- 
gating the  active  cause.  Further  observation  has  also  shown  that  the 
protection  so  conferred  is  only  relative.  Dogs  can  always  be  infected 
with  the  blood  of  such  animals.  It  has  long  been  known  in  Africa  that 
antelopes  and  buffaloes  harbour  trypanosomata  in  their  blood  without 
showing  external  signs  of  disease. 

Another  method  of  protection  must  therefore  be  sought,  such  as 
destroying  the  various  stinging  flies ;  but  this  offers  little  hope  of 
success.  Koch  admits  that  he  sees  no  method  of  dealing  with  them. 
The  other  method  is  directed  against  the  parasite,  and  here  he  seems 
more  hopeful.  The  disease  can  be  rooted  out  by  killing  all  diseased 
animals  suspected  of  disease.  The  line  of  procedure  is  indicated  by  the 
experience  gained  in  Mauritius  and  Java.  When  surra  broke  out  in 
Mauritius  almost  all  the  oxen  died  in  two  years.  In  Java  the  nature  of 
the  disease  was  early  recognised,  and  all  suspected  animals  were  at  once 
slaughtered  or  isolated  until  slaughtered ;  in  this  way  the  disease  was 
soon  stamjied  out. 

LOUPING'ILL. 

The  close  analogy  between  the  convulsive  form  of  the  disease 
described  as  "  trembling  "  (which  disease  is  well  known  in  France)  and 
the  condition  known  in  Britain  as  louping-ill  lead  us  to  give  here  a  short 
account  of  the  latter  condition.  For  a  great  part  of  what  follows  we  are 
indebted  to  articles  by  Meek  and  Greig  Smith,  published  in  the  Veteri- 
narian, Vol.  T.XIX,  Nos.  820  and  840. 

Nature  and  Symptoms  of  the  disease.  The  disease  known  usually 
as  louping-ill  or  trembling  has  long  been  of  annual  and  sometimes  of 
biennial  recurrence  in  certain  parts  of  Great  Britain.  In  these  places 
sheep  farmers  look  for  the  appearance  about  the  middle  of  April,  to  its 
continuation  during  May,  and  to  its  gradual  disappearance  early  in  June. 
Lambs  are  most  liable,  but  sheep  are  also  quite  susceptible  to  the  disease, 
and  in  both  the  symptoms  are  the  same.    The  disease  under  consideration 


430  DISEASES   OF   THE   BLOOD. 

is  rendered  quite  distinct  by  certain  well-known  symptoms.  Though 
these  have  been  described  in  various  ways,  the  disease  can  be  recognised 
by  the  more  or  less  complete  paralysis  of  the  body  and  limbs.  Symptoms 
may  succeed  one  another  very  rapidly,  or  may  be  spread  over  some  length 
of  time.  The  animal  at  first  loses  control  over  the  muscles,  which  are 
seen  to  twitch  convulsively.  It  may  fall  down  and  struggle  on  the 
ground,  sometimes  jumping  up  again,  often  to  some  height.  Between 
the  fits  it  is  often  seen  to  stand  trembling.  These  symptoms  are  fre- 
quently accompanied  by  frothing  at  the  mouth.  Some  such  appearances 
are  the  usual  onset  to  the  disease,  and  are  followed  by  a  paralysis  which 
usually  affects  the  hind  limbs,  but  may  also  include  more  or  less  of 
the  body  and  the  head  and  neck.  The  fore-limbs  are  often  similarly 
paralysed.  The  affected  limb  or  limbs  become  cold  to  the  touch.  The 
paralysis  necessarily  brings  the  animal  to  the  ground,  though  it  may  be 
able  to  crawl  about  by  the  aid  of  the  unaffected  legs.  When  the  head 
and  neck  are  affected  the  former  is  usually  drawn  to  one  side,  and  the 
eyes  often  become  oblique.  Excitement  is  greatly  increased  when  the 
animal  is  disturbed.  The  symptoms,  then,  in  a  few  words  are  more  or 
less  complete  paralysis,  preceded  as  a  rule  by  fits  and  trembling. 

The  small  number  which  recover  present  "  a  wry  neck,  stiff"  joint, 
high  back,  or  other  deformity."  During  recovery  swellings  occur  at  the 
joints ;  these  may  be  pierced  with  good  results,  giving  a  large  discharge 
of  pus.  According  to  Fair,  in  the  Veterinarian,  Vol.  VIIL,  "these  abscesses 
usually  appear  in  the  neighbourhood  of  the  joints,  but  sometimes  above 
the  arms,  the  brisket,  or  any  neighbouring  part  of  the  body." 

While  the  disease  is  characteristically  a  sheep  ailment,  other  animals 
are  also  liable.  Swine  fed  with  the  carcases  or  blood  of  sheep  which 
have  succumbed  to  louping-ill  die  with  every  characteristic  of  the  disease 
in  a  short  time.  If  the  carcase  has  been  boiled  this  does  not  occur. 
Swine  will  also  frequently  take  the  malady  if  allowed  access  to  the  grass 
of  aff'ected  fields.  Cattle  are  said  to  take  the  disease,  and  in  the  North 
Tyne  district  it  is  said  that  if  a  cow  takes  louping-ill,  the  milk  will  give 
the  illness  to  a  calf  or  lamb.  One  or  two  cases  of  horses  being  attacked 
are  also  reported. 

Kegarding  the  infectious  character  of  louping-ill,  the  following  is  very 
well  known.  Sheep  bred  on  diseased  places  are  not  nearly  so  liable  to 
the  disease  as  sheep  which  have  been  introduced  from  unaffected  places. 
Louping-ill  may  be  introduced  into  a  new  place,  but  in  such  cases, 
unless  the  importation  from  affected  farms  be  continued,  the  malady 
may  disappear. 

Distribution  of  the  disease.  In  Great  Britain  it  is  confined  to  the 
North  Tyne  district  of  Northumberland  and  to  the  contiguous  border 
counties    of    Scotland,    extendin*;;    into    Kirkcudbri^j-htshire    and   certain 


LOUPING-ILL. 


431 


valleys  of  Dumfriesshire.  It  is  rare  in  Berwickshire,  common  in 
the  north  and  west  of  Roxburghshire  and  the  similar  hilly  districts 
of  Selkirkshire  and  Peeblesshire.  It  occurs  in  Ayrshire,  to  a  slight 
extent  in  Lanarkshire,  and  is  found  in  the  western  parts  and  islands  of 
Argyleshire  and  Inverness-shire. 

Not  only  is  the  disease  very  circumscribed  in  its  distribution  as  a 
whole,  but  locally  in  the  places  mentioned  infected  and  non-infected 
spots  are  pointed  out.  These  may  be  quite  contiguous.  The  flocks  in 
the  North  Tyne  district  feed  up  and  down  the  hills  in  limited  "  cuts," 
and  it  is  one  of  the  features  of  the  illness  that  certain  "  cuts  "  are  very 
liable  to  it,  while  others,  even  on  the  same  farm,  are  just  as  free.  In 
many  cases  the  nature  of  the  pasture  is  such  as  to  suggest  to  an  ex- 
perienced man  the  probability  of  its  being  subject  to  the  disease.  A  dry 
and  foggy  pasture  seems  best  suited  for  harbouring  the  cause  of  the 
malady.     These  infected  places  have  remained  wonderfully  constant,  but 


Fig.    198.— Larva   of  the 

grass  tick. 
Length,  j^th  of  1  mch. 


Fig.  199. — Pupa  of  the  grass  tick. 
Length,  TR^h  of  1  inch. 


a  peculiar  feature  about  them  is  that  some  may  be  very  bad  for  louj^ing- 
ill  one  year,  and  others  bad  another  year.  Of  two  adjoining  farms,  one 
may  be  badly  attacked  and  the  other  mildly,  while  in  the  following  year 
the  conditions  may  be  reversed.  Districts  may  present  the  same  pecu- 
liarities. Thus,  though  the  disease  is  essentially  endemic,  it  is  not  abso- 
lutely constant  in  its  recurrence.  There  seem  to  be  certain  circumstances 
capable  of  favouring  or  retarding  it. 

Lesions.  The  chief  lesions  are  localised  in  the  membranes  of  the 
brain  and  spinal  cord,  which  are  congested  or  inflamed,  and  contain  an 
increased  amount  of  cerebro-spinal  fluid  or  a  jelly-like,  sometimes  blood- 
stained exudation.  Softening  and  hardening  of  the  spinal  cord  have  both 
been  observed.  Inflammation  of  the  pleura  and  pericardium,  with  fluid 
or  jelly-like  exudation,  are  common ;  lobar  congestion  of  the  lungs,  endo- 
carditis, gastritis,  and  enteritis  have  all  been  described ;  some  observers 
have  mentioned  congestion  of  the  kidneys  and  liver  and  swelling  of 
the  spleen.  Lesions  of  the  nerve-centres  are  the  most  constant  and 
reliable. 


432 


DISEASES   OF   THE   BLOOD. 


Etiology.  Depressing  and  weakening  influences  of  all  kinds  have 
been  blamed  for  producing  the  disease,  but  the  general  consensus  of 
opinion  points  in  the  direction  of  infection  with  micro-organisms  carried 
and  introduced  into  the  sheep's  system  by  the  common  sheep  tick  or 
"  grass  tick  "  {Ixodes  reduvius).  The  following  remarks  on,  and  illus- 
trations of,  this  parasite  are  from  an  article  by  Mr.  Wheeler,  of  Alnwick 
{Vetcrinanan,  Vol.  LXXIII.,  No.  867,  p.  141). 

Life  History  of  the  Grass  Tick.  Sheep  ticks  (which  must  not  be 
confused  with  the  sheep-ked,  or  keb,  a  wingless  six-legged  fly,  universal 
on  sheep  everywhere)  are  allied  to  the  spiders.  They  pass  through  four 
stages  of  existence:  the  egg — the  six-legged  larva — the  eight-legged 
pupa — and,  finally,  the  eight-legged  adult  male  or  female. 

In  each  of  the  three  stages  of  larva,  pupa,  and  adult  female,  all 


Fig.  200. — Adult  male  of  the  grass 
tick.     Length,  ^th  of  1  inch. 


Fig.  201.— Adult  female.     Length,  |th  of  1  inch. 


species  of  ticks  attack  some  "  host  "  or  animal,  either  beast,  bird,  or 
reptile,  to  which  they  attach  themselves  by  the  "  rostrum  "  or  beak,  and 
become  greatly  distended  by  suction  of  the  host's  blood.  When  replete 
they  fall  to  the  ground — if  a  larva  or  pupa,  in  order  to  undergo  its 
metamorphosis  to  the  next  stage  of  its  existence,  and  afterwards  seek  a 
fresh  host ;  if  an  adult  female,  to  lay  its  eggs  amongst  herbage.  The 
adult  male  is  not  capable  of  distension  by  suction,  though  it  equally 
attaches  itself  to  a  host. 

After  undergoing  metamorphoses,  grass  ticks,  with  the  exception  of 
males,  are  light  in  colour,  soft  and  lethargic,  and  remain  concealed  for 
some  time  while  recovering  strength  before  seeking  a  fresh  host. 

Professor  Neumann  alludes  to  the  fact  that  a  fresh  host  is  sought  by 
ticks  three  several  times  during  their  existence. 


LOUPING-ILL. 


433 


The  Larva.  When  first  hatched  out  from  the  eggs,  which  are  sup- 
posed to  be  laid  at  the  roots  of  coarse  herbage,  the  young  ticks  are 
white  and  soft,  but  soon  gain  strength.  Provided  the  weather  is  favour- 
able, they  climb  up  the  stems,  and,  holding  by  their  two  posterior  pairs 
of  legs,  await  the  passing  of  a  host,  employing  their  two  front  legs  as 
insects  use  their  antennae. 

In  this,  as  in  other  "  free  living  "  stages  of  their  existence,  the  young 
larvae  show  great  activity,  attaching  themselves  and  clinging  tenaciously 
to  any  moving  object.  They  appear  to  be  more  numerous  on  the  rank 
rushes  growing  in  damp,  undrained  places. 

On  finding  a  host,  larvae  attach  themselves  by  the  rostrum,  and  remain 
there  for  about  two  days,  by  which  time  they  are  distended,  black  and 
globular.    At  this  time  they  are  easily  detached 
from  the  host,  and  have  lost  their  activity  and 
clinging  habits. 

The  Pupa.  The  possession  of  eight  legs  dis- 
tinguishes the  pupa  easily  from  the  larva.  The 
extra  pair  are  placed  behind  the  others.  After 
the  metamorphosis,  the  pupa  takes  up  its  posi- 
tion on  the  stalks  of  herbage,  just  as  the  larva 
had  done,  for  another  chance  of  attachment  to 
a  host.  But  whereas  adult  grass  ticks  seem  to 
confine  themselves  mostly  to  sheep,  cattle,  and 
deer,  the  larvae  and  pupae  attach  themselves 
very  readily  to  various  hosts,  such  as  horses, 
dogs,  and  even  human  beings.  After  about 
four  days  the  pupa  is  again  replete  with  blood, 
black  and  opaque,  and  again  drops  to  the 
ground  to  undergo  its  second  and  final  change. 

Adults.  On  reaching  the  adult  age,  both  males  and  females  again 
wait  on  herbage  for  a  passing  host.  At  this  time,  as  well  as  after  dis- 
tension of  the  female  on  the  host,  an  action  which  appears,  to  be  sexual 
intercourse  freely  takes  place,  even  in  confinement.  On  the  host  the 
females  gradually  distend  (Fig.  202),  and  in  the  course  of  so  doing  vary 
much  in  colour  and  appearance.  When  fully  replete,  the  female  Ixodes 
reduvins  becomes  globular  and  black.  One  taken  in  this  condition  on 
April  15th  commenced  to  lay  on  May  12th,  and  a  few  others  taken  at 
the  same  time  commenced  shortly  afterwards. 

Grass  ticks  never  remain  on  the  host  to  undergo  metamorphosis  or  to 
lay  eggs.  They  must  therefore  during  their  cycle  of  existence  contrive 
to  find  a  fresh  host  no  fewer  than  three  times. 

In  an  article  published  in  the  Transactions  of  the  Highland  and 
Ag.  Soc.  for   1902  Mr.  Wheeler  draws  attention  to  the  close  points  of 

D.C.  F  F 


Fi(i.  202.— Partially  dis- 
tended female.  The 
dotted  white  line  repre- 
sents the  size  of  the 
tick  before  distension. 


434 


DISEASES   OF   THE   BLOOD. 


resemblance  between  louping-ill,  Texas  fever,  tsetse  fly  disease,  surra, 
heart-water,  yellow  fever,  and  malaria. 

In  the  article  previously  referred  to  he  summarises  his  conclusions 
as  follows  : — 

One  species  only  of  tick,  Ixodes  rediiriiis,  commonly  known  as  the 
grass  tick,  has  been  found  to  carry  the  louping-ill  bacillus  to  the  sheep. 
It  is  easily  recognised  by  the  red  body  of  the  young  females,  the  legs, 
shield,  etc.,  being  dark  brown. 

It  lays  its  eggs,  and  undergoes  its  metamorphoses,  in  coarse 
herbage,  and  after  each  change  seeks  a  fresh  "  host "  on  which  to 
distend  itself  to  a  large  size  by  suction  of  blood. 

In  all  stages  grass  ticks  abstain  from  all  food  except  when  on  a  host. 


Fig.  203. — Female,  tinder  size. 


Fig.  204. — Headless  female. 


and  they  are  endowed  with  extraordinary  powers  of  fasting  until  a  host 
is  found. 

Ticks  soon  die  of  drought  where  there  is  no  good  harbourage  among 
rank  vegetation. 

Judging  from  analogy,  it  is  probable — 

That  the  bacillus  can  only  be  obtained  from  a  diseased  sheep,  and 
inserted  by  the  tick  into  another  sheep. 

That  ticks  convey  the  bacillus  through  their  eggs  to  their  offspring, 
as  well  as  retain  it  through  their  metamorphoses. 

That  there  is  no  danger  in  removing  sheep  from  foul  ground  to 
cultivated  lowlands,  but  that  the  disease  is  easily  imported  from  one 
hill  farm  to  another. 

Strong  and  fat  animals  are  nearly  as  susceptible  to  attack  as  weakly 
ones. 

If  the  land  is  once  free  of  disease,  it  can  only  be  re-imported  by 
diseased  sheep,  or  ticks  taken  from  them. 


BRAXY.  435 


SUGGESTED    MEASURES    FOR    PREVENTION. 

Burning  and  cutting  of  long  grasses,  l)racken,  rushes,  etc. 

Salt  and  sulphur  given  to  the  sheep. 

Inoculation. 

Eemoval  of  all  diseased  sheep  to  a  separate  inclosure,  where  hand- 
picking  and  dipping  are  carefully  attended  to,  the  pasture  is  kept  short, 
and  damp  places  are  drained.  The  sheep  to  be  confined  to  this  in- 
closure so  long  as  the  tick  season  lasts. 

Immediate  slaughter  and  burial  of  all  affected  sheep. 

BRAXY. 

[The  following  is  a  very  condensed  account  of  a  paper  published  by 
C.  0.  Jensen  on  the  above  disease.  It  first  appeared  in  English  in  the 
Veterinarian,  Vol.  LXIX.,  No.  825,  p.  621,  along  with  the  original 
illustrations.] 

The  name  Braxy  is  applied  to  a  disease  in  some  respects  resem- 
bling anthrax,  which  appears  as  an  epizootic,  and  is  best  known  in 
Iceland,  the  Faroe  Islands,  and  parts  of  Norway,  though  it  also  occurs  in 
Scotland  and  Cornwall.  Krabbe  describes  the  disease  as  infectious,  very 
acute  in  its  course,  and  as  proving  fatal  within  a  few  hours  of  the 
appearance  of  certain  characteristic  swellings  about  the  posterior  parts 
of  the  body.  Post-mortem  reveals  extensive  dark  purplish  staining  of 
the  abomasum  and  distension  of  the  digestive  canal  with  gas,  while  de- 
composition of  the  cadaver  occurs  with  excessive  rapidity,  the  liver  and 
kidneys  undergoing  softening,  the  skin  assuming  a  bluish  tint,  the  wool 
becoming  loose,  and  the  entire  carcase  giving  off  a  most  offensive  stench. 
Krabbe  states  that  the  disease  was  regarded  as  a  form  of  anthrax — a 
view,  however,  in  which  he  does  not  coincide.  Somewhat  later  Messrs. 
J.  Sigurosson,  S,  Jonsson,  and  Einarsson,  all  natives  of  Iceland,  and 
the  Norwegian  State  Veterinary  Surgeon,  Ivar  Nielsen,  carefully  de- 
scribed the  disease,  throwing  considerable  Hght  both  on  the  conditions 
in  which  it  appears  and  on  its  etiology. 

According  to  them,  braxy  is  an  acute,  or  even  exceedingly  acute, 
infectious  disorder,  which  begins  as  a  hsemorrhagic  inflammation  of  the 
mucous  membrane  of  the  abomasum,  is  accompanied  by  excessive  de- 
velopment of  gas  in  the  digestive  canal,  especially  in  the  stomachs,  and 
proves  fatal  in  some  cases  by  a  kind  of  general  infection,  in  others  by  a 
specific  intoxication,  or  by  dyspnoea  due  to  tympanites. 

Braxy  commits  its  chief  ravages  during  the  winter  months :  appearing 
first  in  autumn,  the  cases  increase  as  winter  api)roaches,  to  diminish  again 
in  spring  ;  in  summer  they  are  exceedingly  rare.     This  fact  explains  why 

F  F  2 


436  DISEASES   OF   THE   BLOOD. 

the  disease  was  so  long  regarded  as  due  to  climatic  influences.  Even  at 
the  present  day,  when  it  is  known  to  be  due  to  a  specific  organism,  the 
action  of  temperature,  etc.,  must  still  be  regarded  as  i^robably  playing  an 
important  part  in  infection.  The  disease  is  said  not  to  occur  in  mild 
weather  ;  but  whether  or  not  this  be  true,  every  one  is  agreed  that  it  is 
principally  seen  during  frost,  especially  when  frost  is  unaccompanied  by 
snow. 

From  experience  gained  both  in  Iceland  and  Norway,  the  disease 
appears  to  be  often  localised  in  certain  districts  and  fields — a  fact  largely 
accounted  for  when  we  learn  that  up  to  the  present  little  or  no  attempt 
has  been  made  to  prevent  the  spread  of  infection  from  the  dead 
bodies. 

Braxy  chiefly  attacks  young  animals,  and  is  rare  in  those  over  three 
years  of  age.  Hjaltelin  estimates  the  number  of  deaths  in  a  single 
district  during  the  years  1849 — 1854  at  approximately  6,000,  made  up 
as  follows  : — 

Yearling  lambs       . .          . .          . .  . .  .  .  . .  . .  2,440 

Two-year  sheep     .  .          .  .          .  .  . .  . .  . .  .  .  2,460 

Three-year  sheep  .  .          .  .          .  .  . .  . .  .  .  . .  1,020 

Annuals  older  than  three  years  . .  . .  . .  . .  . .  80 

The  younger  animals  suffer  most,  and  in  Norway  Nielsen  directs 
attention  to  the  heavy  fatalities  amongst  lambs. 

Symptoms.  The  sheep  suddenly  appears  ill,  is  dull,  lies  about,  and 
cannot  be  induced  to  rise  ;  all  movement  seems  to  give  pain,  and  from 
time  to  time  the  animal  groans  ;  the  posterior  parts  of  the  body  become 
swollen,  and  a  little  froth  often  escaj^es  from  the  mouth.  The  pulse 
varies  between  thirty  and  thirty-five  per  minute,  and  is  often  imperceptible 
in  the  extremities  ;  the  temperature  may  rise  to  105°  or  even  108°  Fahr. 
This  condition  may  last  some  hours,  and  always  ends  with  the  animal's 
death;  sheep,  which  overnight  had  shown  no  signs  of  illness,  are  often 
found  dead  in  the  morning.  The  incubation  period  is  from  forty-eight  to 
sixty  hours,  but  ordinary  cases  seldom  live  longer  than  from  five  to  eight 
hours  after  the  symptoms  declare  themselves. 

The  striking  post-mortem  appearances,  especially  the  haemorrhagic 
inflammation  of  the  abomasum,  were  early  the  subject  of  remark.  This 
appearance  is  very  characteristic. 

If  the  animals  are  slaughtered,  the  most  important  change  is  found  to 
be  a  purplish,  dark,  somewhat  swollen  patch  in  the  abomasum;  during 
the  course  of  the  disease  this  increases  in  size,  and  if  the  animal  should 
be  allowed  to  die  of  braxy  the  entire  abomasum  shows  haemorrhagic  or 
sero-hsemorrhagic  infiltration ;  the  abomasum  and  the  first  part  of  the 
small  intestine  usually  contain  no  food,  but  may  often  show  a  certain 
amount  of  bloody  fluid.     This  haemorrhagic  inflammation  may  extend  in 


BRAXY. 


437 


a  forward  direction,  implicating  the  other  stomachs,  or  backward,  in- 
vading the  small  or  both  small  and  large  intestines.  The  other  parts  of 
the  intestinal  canal  are  congested.  The  pleural  and  peritoneal  cavities 
contain  a  little  serous  fluid.  The  blood  is  dark  in  colour,  but  may  be 
clotted  ;  the  spleen  is  at  times  somewhat  swollen,  at  others  normal.  The 
liver  is  usually  light-coloured,  soft,  and  degenerated  ;  occasionally  this 
degenerative  process  is  extremely  marked,  but  due  allowance  should 
always  be  made  for  post-mortem  change.  The  kidneys  may  appear 
degenerated ;  in  many  cases  they  are  enlarged  and  soft,  or  almost  fluid 


Fig.  205. — The  shaded  areas  of  the  above  map  indicate  the  distribution  of  braxy. 


in  consistence.  The  carcase  decomposes  very  rapidly;  within  a  short 
time  of  death  the  belly  is  distended  with  gas,  the  rectum  protrudes  at 
the  anus;  the  skin  assumes  a  bluish  colour  in  places,  and  the  wool  falls 
out ;  sometimes  the  skin  bursts,  revealing  the  presence  in  the  sub- 
cutaneous tissue  of  a  sero-haemorrhagic  fluid. 

Braxy  is,  then,  a  primary  violent  hsemorrhagic  inflammation  of  the 
abomasum,  with  or  without  secondary  general  infection. 

From  careful  study  it  seems  quite  certain  that  the  Scottish  "  braxy 
is  identical  with  the  Norwegian  and  Icelandic  "  bradsot  "  ;  it  appears  at 


438  DISEASES   OF   THE   BLOOD. 

the  same  season,  and  is  intimately  connected  with  cHmatic  influences  ;  it 
runs  its  course  so  rapidly  that  animals  left  healthy  at  night  are  found 
dead  in  the  morning  ;  and  the  pathological  anatomy  of  hraxy  is  the  same 
as  that  of  "  hradsot." 

To  Ivar  Nielsen,  of  Bergen,  must  he  ascribed  the  honour  of  elucidating 
the  etiology  of  braxy.  During  the  course  of  investigations,  published 
in  1888,  lie  found,  partly  in  the  local  lesions  of  the  intestinal  track,  partly 
in  the  capillaries  of  the  internal  organs,  a  special  bacillus,  easy  to  distin- 
guish from  that  of  anthrax,  of  which  he  gives  the  following  description : 

"  The  bacilli   {B.    fiastromycocis-oris)   are  oval,  of  a  length  varying 
from  2  to  6  micromillimetres,  and  a  thickness  of  one  micromillimetre. 
They  are  often  in  pairs,  arranged  in  a  straight  line  or  meeting  at  an 
angle ;  in  the  former  case,  and  especially  if  deeply  stained,  the  pair  may 
present  the  appearance  of  a  single  bacillus.     Occasionally  they  form  long 
chains.     Near  the  centre  of  the  bacillus,  but  not  always  centrally  placed, 
may  often  be  found  a  zone  measuring  more  than  half  the  total  length  of 
the  bacillus,  and  exhibiting  little  or  no  colouration.    It  appears  as  though 
the  stained  portions  gradually  contracted,   finally  forming  two  deeply 
coloured  masses  at  the  poles  of  the  lemon-shaped  bacillus,  which  then 
somewhat  resembles  the  bacillus  of  rabbit  septicaemia,  except  that  the 
unstained  part  of  the  braxy  bacillus  is  larger  and  more  rounded,  appear- 
ing to  be  bulged  out  laterally.     In  dry  preparations  the  bacillus  is  easily 
recognised  on  account  of  the  highly  refractile  character  of  the  colourless 
portion  ;  but  in  sections  careful  search  is  often  required,  especially  if  the 
section  be  somewhat  thick.     Whether  the  colourless  portion  represents  a 
spore  cannot  at  present  be  said,  though  such  appears  probable.     The 
bacillus  is  always  found  in  the  mucous  membrane  of  the  abomasum,  and 
especially  in  the  submucous  and  subserous  connective  tissue.     In  the 
other  organs  the  bacillus  may  be  present  in  considerable  numbers,  or,  on 
the  other  hand,  may  be  impossible  to  detect." 

The  same  bacillus  has  been  found  in  the  tissues  of  affected  sheep  both 
in  Norway  and  in  Iceland;  the  bacillus,  when  subcutaneously  injected, 
produces  a  violent  hsemorrhagic  inflammation  of  the  same  character  as 
one  finds  in  the  abomasum  in  cases  of  spontaneous  braxy,  and  the  local 
changes  at  the  point  of  inoculation  may,  just  as  in  spontaneous  braxy, 
be  accompanied  l)y  a  general  infection  with  degeneration  of  difterent 
organs,  and  with   softening  of  the  kidney  substance. 

The  bacillus  of  braxy  is  anaerobic.  In  cultures  it  develops  consider- 
able quantities  of  gas,  just  as  it  does  when  inoculated  into  the  tissues. 
It  is  closely  related  to  the  bacillus  of  symptomatic  anthrax,  which  it  some- 
what resembles  in  general  appearance,  and  of  wdiich  it  reminds  one  by 
its  ability  to  produce  hfemorrhagic  inflammation  in  the  muscular  tissues. 
It  is  distinguished  from  the  last  named,  however,  by  being  pathogenic  to 


BILHARZIOSIS    IN    CATTLE    AND    SHEEP.  439 

swine,  mice,  pigeons,  and  poultry,  which  are  not  killed  by  the  bacillus  of 
symptomatic  anthrax. 

The  bacilli  of  braxy,  malignant  oedema,  symptomatic  anthrax,  together 
with  Ivar  Nielsen's  shortly  described  bacillus  of  whale's  septicaemia,  and 
Thoma's  bacillus  of  malignant  emphysema  (found  in  extensive  sub- 
cutaneous inflammation  and  emphysema  in  man),  and  certain  others  less 
well  known,  form  a  group  of  closely  allied  bacilli  resembling  one  another 
in  form,  in  being  anaerobic,  and  in  producing  a  sero-haemorrhagic  inflam- 
mation and  emphysema,  but  differing  in  the  manner  of  producing  their 
effects. 

Experience  and  analogy  both  seem  to  indicate  that  young  animals 
occasionally  suffer  from  mild  attacks  of  braxy  from  which  they  recover. 
Such  animals  afterwards  exhibit  a  well-marked  immunity  against  the 
disease. 

Ivar  Nielsen  attempted  to  vaccinate  against  braxy  by  a  method 
resembling  that  used  in  black-quarter.  He  dried  the  diseased  kidney 
tissue,  and  injected  subcutaneously  small  quantities  of  the  material  thus 
obtained  suspended  in  water.  A  slight  local  inflammation  followed,  which 
appeared  to  protect  against  later  "  spontaneous  "  infection.  He  has  used 
this  method  in  his  own  district,  and  states  that  it  is  also  practised  to  some 
extent  in  Iceland.  As  far  as  one  can  judge — and  of  course  a  just  opinion 
is  very  difficult  to  form — these  inoculations  appear  of  value. 

The  result  of  experiment,  considered  in  conjunction  with  the  good 
results  of  inoculation  for  black-quarter,  would  seem  to  indicate  that 
Nielsen's  method  of  vaccination  against  braxy  may  yet  prove  of  the 
greatest  possible  value,  although  the  method  will  doubtless  require 
modification  in  its  details. 

These  modifications  -Jensen  enumerates  at  some  length. 

(Mr.  Dollar  has  been  informed  that  Professor  Hamilton  and  Dr.  McCall 
have  been  engaged  in  an  investigation  regarding  the  possibility  of  con- 
ferring immunity  against  braxy,  and  that  a  Government  report  will  be 
issued  on  the  subject.  Up  to  the  present  time  however — April,  1905 — he 
has  not  been  able  to  obtain  this  report  or  any  advance  proof  sheets  of  it.) 

BILHARZIOSIS    IN    CATTLE    AND    SHEEP. 

This  disease  is  caused  by  the  bovine  blood  fluke  {ScJdstosoma  bovis 
of  cattle  and  sheep.  Synonyms  :  Bilharzia  bovis ;  Bilharzia  crassa ; 
Gyncecophorus  crassus  ;  Gi/mecoj^liorus  bovis ;  Bilharzia  luematobia  crassa  ; 
Schistosomnm  ijovis. 

Geographical  Distribution.     Egypt,  Italy,  Sicily,  India  (?). 

This  parasite  was  discovered  by  Sonsino  (1876)  in  Egypt  in  the 
portal  veins   of  the  ox,  and  later  he  found  it    in  sheep,  while  Grassi 


440 


DISEASES    OF   THE    BLOOD. 


and  Eovelli  afterwards  found  it  in  about  75  per  cent,  of  the  sheep 
slaughtered  at  Catania,  Sicil3\ 

Source  of  Infection.  CHnical  observation  and  analogy  point  to 
untiltered  drinking  water  as  the  source  of  infection. 

Position  of  the  Parasite.  The  worms  are  found  in  the  veins 
of  the  abdomen,  the  vena  porta,  vena  linealis,  vena  renalis,  and  the 
venous  plexus  of  the  bladder  and  of  the  rectum. 

Symptoms.  The  young  parasites  appear  to  do  no  injury ;  in  fact, 
even  the  adult  worms  seem  to  be  inoffensive  in  themselves.  The  eggs, 
on  the  other  hand,  armed  with  a  sharp  point,  are  the  exciting  cause 
of  the  disease.     The  position  of  the  parasite  in  the  venous  system,  and 


Fig.  206.— The  bovine 
blood  fluke  {Schisto- 
soma  bovis) ,  male  and 
female.  X  9.  (After 
Leuckart,  1894,  p. 
467,  Fig.  204  A.) 


Fig.  207. — Cross  section  of  bovine  blood  fluke 
{Schistoso)7ia  bovis),  showing  the  position  of 
the  female  in  the  gynaecophoric  canal.  X  200. 
(After  Leuckart,  1894,  p.  472,  Fig.  209.) 


the  consequent  location  of  the  agglomeration  of  eggs,  determine  the 
particular  symptoms.  Either  the  genito-urinary  system  is  attacked, 
in  which  case  hsematuria  is  one  of  the  first  symptoms,  or  the  large  in- 
testine is  attacked  and  blood  is  noticed  in  the  fasces. 

If  the  parasites  are  lodged  in  the  venous  plexus  of  the  genito-urinary 
system,  the  chief  symptoms  are  :  haematuria,  j^ains  in  the  lumbar  region, 
the  left  iliac  fossa,  the  thigh,  or  in  the  vulva,  which  may  be  spontaneous 
or  may  accompany  micturition  ;  cystitis,  vesical  calculus,  urinary  fistulas, 
vaginal  verminous  tumours,  nephritis. 

The  eggs  accumulate  in  the  capillaries,  which  they  rupture  ;  they 
traverse  the  mucosa  and  fall  into  the  bladder,  thus  causing  more  or 
less  haemorrhage ;   in  this  way  the  lueinataria  is  established,  which  is 


BILHARZIOSIS    IN    CATTLE    AND    SHEEP. 


441 


often  the  initial  symptom.  At  first  the  urine  is  quite  bloody,  but  it 
gradually  becomes  clearer,  and  it  is  only  at  the  end  of  micturition  that 
muco-purulent  flakes  are  expelled,  in  which  numerous  eggs  and  even 
embryos  are  found  ;  the  urine  contains  also  epithelial  cells,  more  or 
less  pus,  eggs,  and  occasionally  embryos.  On  micturition  sharp  pains 
are  felt  at  the  base  of  the  penis  or  at  the  gland,  possibly  due  to  the 
passage  of  eggs.  The  passage  of  eggs  through  the  walls  of  the  bladder 
gives  rise  to  ci/stitis  ;  blood  be- 
comes more  abundant  in  the 
urine  after  fatigue  or  coitus ; 
clots  may  form  and  cause  reten- 
tion of  urine ;  chronic  urethritis 
may  develop,  evidently  due  to  the 
presence  of  the  eggs.  In  Egypt 
80  per  cent,  of  the  cases  of  vesical 
calculus  in  man  coincide  with 
bilharziosis  ;  the  formation  of  the 
calculi  evidently  results  from  the 
presence  of  the  eggs,  for  the  cen- 
tral nodule  always  contains  one 
or  more  of  these  structures. 
Urinary  fistulte,  opening  on  the 
perineum,  more  rarely  into  the 
rectum,  occasionally  form.  The 
mucosa  of  the  vagina,  also  of  the 
uterus  and  bladder,  becomes  im- 
pregnated with  calcareous  salts. 
Nephritis  develops  in  grave  cases. 

If  the  parasites  lodge  in  the 
veins  of  the  rectum  the  lesions 
caused  are  analogous  to  those 
described  for  the  genito-urinary 
tract. 

The  heart,  lungs,  and  liver  generally  remain  normal. 

Pathology.  The  bladder  is  reduced  in  size,  while  its  wall  is  greatly 
thickened,  due  chiefly  to  hypertrophy  of  the  muscularis  ;  the  mucosa 
is  also  thickened,  and  at  certain  points  it  is  indurated  by  uric  or  cal- 
careous deposits,  but  the  principal  lesion  consists  in  ulcerations  covered 
with  sanious  pus.  Lesions  analogous  to  those  of  the  bladder  are  also 
observed  in  the  lower  third  of  the  ureters,  and  may  extend  as  high  as 
the  kidney ;  the  ureter  is  enlarged  and  tortuous ;  the  mucosa  irregular ; 
its  lumen  may  remain  nearly  normal  in  size,  but  its  wall  becomes  very 
thick :    the    flow   of   urine   may   be   obstructed ;    in    short,   a   veritable 


Fig.  208.— Eggs  of  bovine  blood  fluke 
(Schistosoma  bovis),  showing  the  pecu- 
liar process  on  the  end.  a,  b,  Layers  of 
the  oviduct ;  c,  eggs  in  the  oviduct  X  180 ; 
X,  eggs  deformed  by  pressure ;  y,  spinous 
process  on  end  of  egg  x  700.  (After 
Sonsino.) 


442  DISEASES   OF   THE   BLOOD. 

h3'dro-iiephrosis  obtains,  which  results  in  atrophic  lesions  of  the  kidney, 
and  ma_y  finally  end  fatally. 

The  mesenteric  lymphatjc  glands  may  hypertrophy,  their  substance 
becoming  tumefied,  presenting  small  hsemorrhagic  centres,  and  contain- 
ing eggs.  The  liver  may  contain  eggs  and  become  somewhat  cirrhotic; 
the  eggs  accumulate  in  the  branches  of  the  portal  veins,  or  after 
piercing  the  walls  they  lie  in  the  hepatic  parenchyma.  The  lungs 
may  also  contain  eggs. 

Diagnosis.  The  diagnosis  may  easily  be  made  by  a  microscopic 
examination  of  the  urine  to  determine  the  presence  of  the  egg. 

Prognosis,  etc.  The  seveiity  of  the  disease  varies  directly  with  the 
number  of  parasites  (and  hence  the  number  of  eggs)  in  the  body. 
Fortunately,  in  the  majority  of  cases,  the  number  of  parasites  is  small, 
though  it  may  increase  from  repeated  infections  to  500  or  more.  In 
cases  of  comparatively  light  infection  the  disease  is  reduced  to  a  slight 
chronic  cystitis,  with  now  and  then  exacerbations,  in  course  of  which 
a  slight  amount  of  blood  and  pus  is  passed  in  the  urine.  The  disease 
may  last  for  years  without  apparent  increase.  In  the  most  severe  cases 
death  may  occur  from  various  causes,  rupture  of  the  bladder,  ascending 
pyelo-nephritis,  uraemia,  albuminuria ;  the  patient  may  die  in  marasmus, 
being  exhausted  by  the  dysentery  or  the  anaemia. 

Bilharziosis  is  accordingly  not  such  a  fatal  disease  as  has  sometimes 
been  supposed. 

HEAT  STROKE-OVER-EXERTION. 

In  oxen  and  sheep  heat  stroke  is  rare  as  a  primary  accident,  but  it  is 
frequently  produced  by  over-exertion  resulting  from  the  combined  action 
of  the  sun's  rays,  heat,  and  fatigue  due  to  work  or  travelling. 

It  is  commonest  during  the  hottest  months  of  the  year  in  oxen  doing 
hard  work  or  in  flocks  which  have  been  travelled  considerable  distances. 
It  may  also  be  seen  during  cooler  seasons  as  the  result  of  exceptional 
fatigue. 

The  disease  results  from  a  general  intoxication  which  reacts  most 
markedly  on  the  cerebro-spinal  centres.  It  is  in  fact  a  complex 
intoxication  resulting  from  failure  of  the  natural  excretory  organs  to 
perform  their  function  completely,  and  from  excessive  central  heat 
acting  on  the  nervous  centres. 

Fat  animals  out  of  condition  are  more  readily  attacked  than  work- 
ing animals  or  sheep  reared  in  the  open  air. 

The  symptoms  are  very  characteristic.  Oxen  when  attacked  first 
of  all  show  extremely  rapid  respiration  and  dyspnoea,  announcing  pro- 
gressive asphyxia.  They  move  with  the  nostrils  dilated,  the  eyes 
prominent  and  injected,   the  mouth  open  and  the  tongue  lolling  out. 


HEAT    STROKE — OVER-EXERTION.  443 

Then  all  of  a  sudden  they  come  to  a  stop  beside  a  wall,  or,  if  at  liberty, 
in  a  ditch,  and  refuse  to  move.  They  may  die  rapidly  with  symptoms 
of  asphyxia  if  they  are  forced  to  move  until  completely  exhausted. 
In  others,  after  a  rest  of  several  hours,  the  breathing  becomes  slower, 
the  anxiety  less  and  normal  conditions  return. 

In  sheep  the  same  general  signs  may  be  seen  :  panting  respiration, 
cyanosed  mucous  membranes  and  extreme  anxiety,  while  death  follows 
rapidly  in  the  same  way,  with  symptoms  of  asphyxia. 

The  diagnosis  is  extremely  easy.     The  prognosis  is  grave. 

Treatment  consists  in  prompt  and  free  bleeding  to  prevent  pulmonary 
congestion.  The  animals  should  be  rested  in  a  shady,  sheltered  spot. 
They  should  have  cool  drinks  and  be  sprinkled  over  the  head,  neck,  or 
entire  surface  of  the  body  with  cold  water. 

To  prevent  such  attacks,  fat  animals  should  not  be  moved  for  long 
distances,  or  during  the  hottest  hours  of  the  day,  while  difficult  and 
prolonged  exertion  should  be  avoided. 


CHAPTER    VI. 

DISEASES    OF    THE    LYMPHATIC    SYSTEM. 

Diseases  of  the  lymphatics  are  numerous,  highly  important,  and 
still  imperfectly  understood.  They  follow  various  accidents,  local 
inflammations,  certain  specific  diseases,  such  as  tuherculosis,  and  may 
occur  in  an  isolated  form  without  involving  any  other  part  of  the  body. 


Fig.  209.— Superficial  lymphatic  glands  of  the  head  and  neck.  P,  parotid  gland 
GZ.SM,  submaxillary  gland;  GaSG,  subglossal  gland;  GaPPA,  preparotid  gland 
GaSA,  subatloid  gland ;  GaPS,  prescapular  gland  ;  GaPPE,  prepectoral  gland 
J,  jugular;  l^-^  C,  first  rib. 

Inflammation,  usually  of  infectious  origin,  may  attack  lymphatic 
vessels  (lymphangitis)  or  lymphatic  glands  (adenitis),  giving  rise  either 
to  simple  lymphangitis,  suppurative  lymphangitis,  or  again  to  simple 
or  suppurative  adenitis. 

It  is  unnecessary  to  emphasise  this  point  in  general  surgical  pathology, 
for  it  is  identical  with  that  which  is  observed  in  other  domestic  animals, 
but   in   order   properly  to   detect   the   glandular   symptoms  in    certain 


DISEASES   OF   THE    LYMPHATIC   SYSTEM. 


445 


diseases  peculiar  to  the  lymphatic  apparatus,  and  in  certain  specific 
diseases,  such  as  tuberculosis,  farcy  of  the  ox,  etc.,  it  is  necessary  to 
understand  thoroughly  the  topography  of  the  lymphatic  system. 

Topography  of  the  lymphatic  glandular  apparatus  :  Examination. 
The  lymphatic  glands  are  in  some  cases  superficial,  in  others  deep  seated, 
and  are  arranged  symmetrically  on  either  side  of  the  body. 

Beginning  with  the  head  and  fore  quarters,  the  lymphatic  apparatus 


Fig.  210.— Deep-seated  lymphatic  glands  of  the  head  and  neck.  The  posterior  portion 
of  the  lower  jaw  removed.  P,  pharynx  ;  GE^),  retro-pharyngeal  gland ;  GC,  deep 
cervical  glands  (cervical  chain)  ;  NS,  spinal  nerve  ;  NP,  pneumo-gastric  nerve  ; 
GCs,  superior  cervical  nerve  ganglion;  NMi,  inferior  maxillary  nerve. 

comprises  a  subglossal,  a  preparotid,  a  subatloid,  a  prescapular  and 
several  prepectoral  glands  (Fig.  209). 

None  of  these  glands  are  very  deeply  placed,  and  all  are  easily 
accessible  to  palpation,  provided  their  exact  position  is  known  and 
the  animals  are  not  too  fat. 

The  subatloid  is  a  little  more  difficult  to  detect,  but  in  thin  animals 
the  tips  of  the  fingers  can  easily  be  passed  under  the  wing  of  the  atlas 
so  that  the  condition  of  the  gland  can  be  examined. 

In  a  normal  condition,  any  gland  on  being  examined  conveys  a 
sensation  of  softness  and  elasticity  of  a  special  character  which  never 
varies.     Palpation  is  painless. 

When,  however,  the  gland  is  diseased,  palpation  causes  pain  in  the 
case  of  all  acute  affections.      It  may,   indeed,  be  impossible  to  reach 


446 


LYMPHATIC   SYSTEM. 


the  glands,  as  they  are  buried  sometimes  in  oedematous  swellings  of 
varying  size.  On  the  other  hand,  they  may  be  painless  on  being 
touched,  but  swollen,  hypertrophied,  indurated,  liardened  or  caseous. 

The  deep-seated  glands  of  the  fore  portion  of  the  body  comprise 
the  retro-pharyngeal  and  the  cervical  chain  running  along  the  posterior 
border  of  the  trachea.  Normally  these  glands  cannot  be  examined 
(Fig.  210)  ;  but  when  the  seat  of  certain  morbid  processes,  they  may 
be  so  enlarged  as  even  to  be  readily  visible.  The  larynx  and  pharynx 
are  then    displaced  downwards,  the  depression  between  the  head  and 


G.A 


G.F 


Fig.  211. — Lymphatic  glands  of  the  hmd  quarter.  GG,  Precrural  lymphatic  gland; 
GF,  lumbar  lymphatic  ;  GP,  popliteal  lymphatic  (deep-seated)  ;  GI,  ischiatic 
lymphatic  (deep-seated)  ;  GA,  anal  lymphatic  (deep-seated). 


upper  extremity  of  the  neck  disappears,  together  with  the  depression 
known  as  the  jugular  furrow.  Such  deformities  may  be  either  per- 
fectly symmetrical,  as  in  lymphadenia,  or  (as  is  more  commonly  the 
case)  asymmetrical,  as  in  tuberculosis ;  and  if  inspection  leaves  any 
doubt,  the  glands  may  be  further  examined  by  palpation. 

To  obtain  the  fullest  information  both  hands  should  be  used,  one 
arm  being  passed  over  the  neck  and  the  fingers  engaged  behind  the 
trachea.  The  operator  may  also  stand  in  front  of  the  animal,  whose 
head  should  be  lifted  so  that  the  points  of  the  lingers  can  be  thrust 
deeply  inwards  on  either  side  of  the  trachea  in  the  direction  of  the 
vertebral  column. 


DISEASES    OF   THE    LYMPHATIC    SYSTEM. 


447 


In  the  posterior  portion  of  the  body  the  number  of  glands  that 
can  be  examined  is  much  smaller.  The  gland  of  the  stifle,  also  called 
"  gland  of  the  flank,"  is,  so  to  speak,  the  only  one  which  can  readily 
be  detected  by  examination  or  palpation.  Nevertheless,  in  cases  of 
lymphadenitis,    tuberculosis   of    the   glands,    etc.,    it   becomes  easy    to 


detect  lymphatic  glands  in  the  loose  fold  of  skin  known  as  the  flank. 
These  glands  are  very  small,  and  three  in  number.  They  are  arranged 
in  a  triangle,  one  being  much  more  prominent  than  the  two  others. 
In  exceptional  cases,  little  nodular  glands,  indistinguishable  at  ordi- 
nary times,  may  become  hj^pertrophied.  This  is  particularly  true  of 
the  small  glands  in  the  neighbourhood  of  the  last  rib. 

The   retro-mammary   glands   need    only    be   mentioned,    but   it   is 


448  LYMPHATIC    SYSTEM. 

important  to  know  that  a  deep-seated  popliteal  gland  also  exists 
above  the  semi-tendinosiis  and  semi-membranosus  muscle  in  the  thick- 
ness of  the  muscles  of  the  thigh;  as  also  an  ischiatic  gland  opposite 
the  ischiatic  notch,  which  can  only  be  examined  by  internal  palpa- 
tion from  the  pelvis,  and  an  anal  gland  situated  deeply  on  the  sides 
and  in  front  of  the  sphincter  ani. 

"With  the  exception  of  those  of  the  pelvis  and  of  the  sublumbar 
region,  the  glands  of  the  thoracic  and  abdominal  cavity  cannot  be 
examined,  but  change  in  them  is  indicated  under  certain  circum- 
stances by  clearly  defined  clinical  symptoms,  and  moreover  it  is 
necessary  to  be  able  to  detect  changes  in  these  glands  on  post-mortem 
examination. 

In  the  thoracic  cavity  the  lymphatic  apparatus  comprises  the 
mass  of  the  prepectoral  glands,  which  extends  into  the  anterior  medi- 
astinum between  the  first  ribs  (glands  of  the  entry  to  the  chest),  the 
aortic  lymphatic  gland  situated  beneath  the  dorsal  portion  of  the 
spine  opposite  the  bifurcation  of  the  aorta,  and  the  lymphatic  glands 
of  the  posterior  mediastinum,  one  of  which  is  relatively  small  and  is 
lodged  in  the  concavity  of  the  posterior  aorta,  the  other  large,  elon- 
gated and  situated  immediately  above  the  oesophagus  in  front  of  its 
passage  through  the  diaphragm. 

In  the  abdominal  cavity  a  sublumbar  chain  is  found  situated  on 
the  sides  of  the  lumbo-sacral  portion  of  the  vertebral  column,  the 
mass  of  the  subsacral  lymphatic  glands,  and,  at  the  entrance  to  the 
pelvis,  extending  on  either  side  along  the  course  of  the  external  iliac 
arteries  and  veins  and  resting  on  the  shafts  of  the  iliac  bones,  the 
iliac  glands. 

All  these  glands  are  partly  accessible  to  examination  by  the  rectum. 

Last  of  all,  we  may  mention  the  gland  situated  on  the  hilum  of 
the  liver,  the  mesenteric  glands,  and  the  little  lymphatic  glands  above 
the  sternum. 

In  the  front  limb  the  only  glands  of  importance  from  a  clinical 
standpoint  are  those  of  the  internal  surface  of  the  shoulder,  close  to 
the  divisions  of  the  brachial  plexus. 

When  enlarged  or  invaded  by  any  specific  organism,  they  may, 
by  compressing  the  nerve  trunks,  cause  lameness. 

THE  LYMPHOGENIC  DIATHESIS. 

(lymphadenitis,   LYMPHO-CYTH/EMIA,    myelo-cyth^mia.) 

It  has  been  questioned  whether  the  term  "  lymphogenic  diathesis," 
which  was  employed  in  human  medicine  by  Jaccoud  to  describe  certain 
morbid  conditions  also  found  in  animals  of  the  bovine  species,  should 


THE    LYMPHOGKNrC    DIATHESIS.  449 

continue  in  use.  At  the  present  moment  it  is  difficult  to  determine 
the  question.  Under  any  circumstances  it  has  the  advantage  of 
inchiding  diseases  of  the  lymphatic  system,  indicated  by  hypertrophy 
of  the  lymphatic  glands  (adenitis)  or  by  an  exaggerated  production  of 
white  blood  corpuscles  (leucaemia),  and  the  passage  into  the  general 
circulation  of  products  derived  from  the  lymphatic  apparatus.  For 
these  reasons  it  may  be  employed  here. 

Clinical  investigation  long  ago  demonstrated  that  in  man  certain 
pathological  conditions  were  characterised  by  a  peculiar  colour  of  the 
blood,  due  to  the  presence  of  white  blood  corpuscles  in  excessive 
quantities,  whence  the  names  "  leucaemia "  (Virchow)  and  "  leuco- 
cythaemia  "  (Bennett).  In  the  same  way  it  has  been  shown  that  the 
change  in  the  blood  characterised  by  a  superabundance  of  white  blood 
corpuscles  generally  coincides  with  engorgement  or  more  or  less 
marked  hypertrophy  of  the  lymphatic  system  and  of  the  adenoid 
tissue  of  the  body  (lymphatic  glands,  spleen,  bone  marrow,  and,  in 
exceptional  cases,  liver,  kidneys,  etc.) — leuco-cythaemic  lymphadenitis  ; 
but  that  many  cases  also  occur  in  which  this  hypertrophy  of  the 
adenoid  tissue  or  of  the  lymphatic  gland  tissue  may  exist,  without 
any  excessive  number  of  white  blood  corpuscles  in  the  l)lood,  whence 
the  name  "  aleucaemic  lymphadenitis  or  pseudo-leucaemia."  Cases  of 
true  leucaemia  without  adenitis  are  much  rarer,  the  lesions  therein 
being  confined  to  the  adenoid  tissue  of  the  bone  marrow. 

These  three  morbid  conditions — leucaemic  lymphadenitis,  or  leuco- 
cythaemia ;  aleucaemic  or  pseudo-leucaemic  lymphadenitis,  or  more 
simply  adenitis ;  and  true  or  simple  leucaemia — are  frequently  found 
in  the  bovine  species.  Whilst  stating  that  these  diseases  are  frequent, 
we  must,  however,  be  understood  to  except  the  numerous  cases  of 
tuberculous  lesions  formerly  included  under  the  same  head. 

Jaccoud  has  shown  that  in  reality  the  causes  of  these  three  morbid 
conditions  are  very  similar,  and  that  a  case  which  at  first  appears  to 
be  of  the  nature  of  aleucaemic  lymphadenitis  may  later  become  trans- 
formed into  leucaemic  lymphadenitis ;  or,  inversely,  that  a  case  which 
at  first  appeared  to  be  a  simple  leucaemia  might  often  become  com- 
plicated with  lymphadenitis :  hence  the  grouping  of  these  different 
morbid  conditions  under  the  heading  of  lymphogenic  diathesis. 

Investigations  have  now  thrown  more  light  on  the  subject  because  of 
the  more  perfect  recognition  of  the  varieties  of  white  blood  corpuscles, 
and  the  above-mentioned  morbid  conditions  may  be  defined  as  follows : — 

(1.)  The  first  variety  consists  of  a  more  or  less  marked  adenitis  or' 
lymphadenitis  without  leucaemia  (aleucaemic  lymphadenitis). 

(2.)  The   second  variety,  consisting  of   leuca3mic   lymphadenitis,  or 
leuco-cythaemia,    is    a    lymphatic    lucaemia    or    lympho-cythaemia,    the 
D.c.  G  G 


450  LYMPHATIC    SYSTEiM. 

anatomical  characteristic  of  which  is  enlargement  of  lymphatic  glands, 
and  the  histological  characteristic  increase  in  number  of  the  large 
and  small  lymphocytes. 

(3.)  A  third  variety,  formerly  regarded  as  simple  leucfemia  without 
Ijanphadenitis,  is  myelogenic  leucaemia  or  myelo-cythtemia,  the  ana- 
tomico-pathological characteristic  of  which  is  to  be  found  in  myeloid 
hypertrophy  of  the  bone  marrow,  giving  to  the  bone  marrow  on  post- 
mortem examination  a  puriform  appearance,  and  in  the  myeloid 
condition  of  the  spleen. 

Histologically  this  variety  is  characterised  by  an  absolute  increase 
in  numbers  of  the  large  mono-  and  poly-  nuclear  eosinophile  leucocytes. 

Symptoms.  Simple  lymphadenitis  begins  in  an  insidious  manner, 
and  is  characterised  by  weakness,  anaemia,  paleness  of  the  mucous 
membranes,  and  wasting  without  apparent  reason,  although  the  appe- 
tite is  preserved.  It  is  only  at  a  later  stage  that  the  glandular  enlarge- 
ments are  discovered  (adenitis),  and  often  this  discovery  is  not  made 
until  the  veterinary  surgeon  is  called  in. 

The  existence  of  the  disease  is  indicated  by  enlargement  of  the 
superficial  glands,  and  this  enlargement,  which  may  commence  at  any 
point,  extends  along  the  course  of  the  lymphatic  vessels  to  the  neigh- 
bouring glands,  until  in  a  shorter  or  longer  time  it  involves  all  the 
lymi^hatic  glands  in  the  body. 

The  enlargement  of  the  glands  is  usually  symmetrical,  and  on 
clinical  examination  it  is  sometimes  easy  to  detect  at  the  outset 
an  increase  in  size  of  the  retro-pharyngeal  glands,  the  glands  of  the 
neclv,  the  prescapular  glands,  the  glands  of  the  flank,  etc. 

Eectal  exploration  reveals  hypertrophy  of  the  glands  of  the  pelvis 
and  of  the  sublumbar  region,  etc.  The  animals  waste  very  rapidly, 
and  sometimes  in  a  few  months  become  incapable  of  standing.  They 
develop  cachexia,  and  die  in  a  state  of  exhaustion,  with  no  other  lesions 
than  those  of  lymphatic  hypertrophy.  Neither  do  they  exhibit  any 
marked  increase  in  the  number  of  white  corpuscles  in  the  blood. 

In  lympho-cythaemia  the  beginning  of  the  disease  is  often  identical 
with  that  of  simple  lymphadenitis,  the  increase  in  the  number  of  white 
blood  corpuscles  not  occurring  until  later.  In  other  cases,  on  the  con- 
trary, leucaemia  appears  first,  and  the  enlargement  of  the  lymphatic 
gland  follows ;  but  what  characterises  this  form  and  allows  of  it  being 
distinguished  from  myelo-cythaemia  is  the  great  increase  in  the  number 
of  large  or  small  lymphocytes.  The  development  is  identical  with,  and 
sometimes  much  more  rapid  than,  that  of  the  preceding  form.  The 
animals  waste  away  and  become  anaemic  and  cachectic,  dying  at  last 
in  a  state  of  absolute  exhaustion. 

Post-mortem    examination    reveals,   as    in    the   previous   condition. 


THE    LYMPHOGENIC   DIATHESIS.  451 

symmetrical  hypertrophy  of  all  the  lymphatic  glands ;  the  spleen  is 
very  often  enormous,  and  the  liver  is  sometimes  affected,  as  are  also, 
in  exceptional  cases,  the  kidnej^s. 

It  may  happen  that  the  spleen  alone  appears  affected,  or  at  least 
that  it  has  been  first  attacked,  a  fact  which  explains  the  existence  of 
leucaemia  before  any  enlargement  of  the  lymphatic  glands. 

Causation.  The  causes  of  lymphadenitis  and  of  lympho-cythfemia 
are  unknown  in  veterinary  as  in  human  medicine.  Apparently  these 
diseases  are  more  common  in  adults  than  in  young  animals.  Some 
regard  them  as  infectious  in  character,  but  this  can  hardly  be  the 
ease,  as  all  experimental  attempts  to  transmit  the  diseases  have  failed. 
It  is  more  plausible  to  compare  the  development  of  these  morbid 
conditions  with  that  of  malignant  tumours,  and  although  some  doubt 
still  exists,  simple  lymphadenitis  may  be  described  as  an  aleucffimic 
lymphoma  or  lympho-cytoma,  which  has  gradually  become  generalised, 
spreading  by  way  of  the  lymphatic  channels  from  the  gland  first  affected 
through  the  surrounding  glandular  system.  Lympho-cythaemia,  on  the 
other  hand,  may  be  said  to  be  a  leucaemic  lympho-cytoma,  which  spreads 
both  by  the  blood  circulation  and  by  the  lymphatic  paths  (spleen, 
haematopoietic    glands    and    organs). 

This  view  of  the  development  of  the  lesions  enables  us  to  class 
lympho-sarcomata  with  lymphomata  and  lympho-cytomata.  The 
malignant  character  and  extremely  rapid  development  of  lympho- 
sarcomata  appear  due  to  its  extending  by  contiguity  of  tissue,  and 
simultaneously  by  the  lymphatic  paths. 

This  new  grouping  would  consequently  place  on  one  side  myelogenic 
leucaemia,  also  called  myelo-cythaemia,  which  is  perhaps  a  different  mor- 
bid species.  This  would  destroy  the  unity  implied  in  Jaccoud's  theory 
of  the  lymphogenic  diathesis  ;  but  for  all  that  this  method  of  grouping 
might  be  justified  by  reference  to  specific  cellular  characteristics.  In 
myelo-cythaemia  the  disease  appears  to  commence  as  a  lympho- 
cythaemia,  i.e.,  it  is  unaccompanied  by  enlargement  of  lymphatic 
glands  or  hypertrophy  of  the  spleen  or  liver,  though  the  blood  ap- 
pears leucaemic.  The  condition  is  not  a  leucaemia  due  to  lympho- 
cytes, but  rather  a  leucaemia  produced  by  mono-  and  poly-  nuclear 
eosinophile  leucocytes,  i.e.,  leucocytes  derived  from   the  bone  marrow. 

The  patients  are  carried  off'  rapidly  after  persistent  wasting,  decline 
and  cachexia,  whilst  on  post-mortem  examination  the  puriform  aspect 
of  the  bone  marrow  is  an  extremely  striking  characteristic. 

Diagnosis.  There  is  rarely  much  difficulty  as  regards  the  diagnosis. 
The  enlargement  of  the  lymphatic  glands,  for  instance,  can  readily  be 
detected,  and  the  only  disease  with  which  this  can  possibly  be  confounded 
is  tubercular  enlargement. 

GG    2 


462  LYMPHATIC    SYSTEM. 

With  the  means  at  present  available  for  diagnosing  tuberculosis, 
such  as  microscopic  examination  of  the  discliarge,  inoculation  with 
discharge,  examination  of  material  from  the  glands,  injection  of 
tuberculin,  etc.,  the  nature  of  the  disease  can  always  be  placed 
beyond   doubt. 

In  lympho-cythfemia  and  in  myelo-cythsemia,  the  ^vhitish-violet 
lactescent  appearance  of  the  blood  is  of  unmistakable  significance, 
particularly  when  the  manifest  progressive  wasting  of  the  whole 
system  is  taken  into  account. 

Histological  examination  of  the  blood  after  fixation  and  staining 
will  in  the  former  cases  reveal  the  presence  of  very  large  numbers  of 
lymphocytes,  and  in  the  latter  an  absolute  increase  in  the  number  of 
the  mono-  and  poly-  nuclear  lymphocytes.  It  should  be  easy,  therefore, 
to  distinguish  the  two  diseases,  especially  as  other  symptoms  vary. 

In  the  early  stages  leucaemia  may  be  mistaken  for  the  leucocytosis 
seen  in  infectious  diseases.  These  forms  of  leucocytosis  are  very  com- 
mon in  animals  of  the  bovine  species.  They  occur  in  certain  forms  of 
tuberculosis,  in  uterine  infections,  in  cases  of  internal  suppuration,  in 
tumour  of  the  heart,  the  rumen,  etc.,  and  vary  in  so  far  as  one  style  or 
another  of  white  blood  corpuscle  predominates.  The  diagnosis,  there- 
fore, necessitates  that  the  white  blood  corpuscles  should  be  counted,  and 
whenever  it  is  found  that  their  variations  in  number  are  no  more  than 
between  5,000  and  15,000  per  cubic  millimetre,  the  case  may  be  regarded 
as  one  of  temporary  leucocytosis. 

If,  on  the  other  hand,  those  corpuscles  numl)er  more  than  from 
15,000  to  20,000,  or,  as  may  sometimes  happen,  they  attain  to  from 
200,000  to  300,000  per  cubic  millimetre  (one  white  to  two  or  three 
red  blood  corpuscles),  the  case  is  one  of  leucaemia,  and,  according  to 
the  predominance  of  the  particular  type  of  cell,  it  is  a  lympho- 
cythaemia  or  a  myelo-cythpemia. 

In  leucaemic  conditions  the  red  blood  corpuscles  are  also  present 
in  fewer  than  the  normal  numbers.  They  are  more  irregular,  assume 
giant  and  dwarf  forms  (macrocytes  and  microcytes),  sometimes  exhibit 
lacunae,  and  are  always  polychromatophile,  i.e.,  without  special  affinity 
for  any  particular  constituent  of  double  or  triple  stains. 

Prognosis.  The  prognosis  of  diseases  included  in  the  lymphogenic 
diathesis  is  extremely  grave,  and  in  the  present  state  of  our  knowledge 
it  may  be  assumed  that  sooner  or  later  death  is  inevitable. 

Treatment.  Treatment  can  scarcely  be  considered  to  exist,  for  at 
the  best  it  can  only  delay  the  development  of  the  disease.  Neverthe- 
less, and  with  this  reservation,  it  is  certain  that  preparations  of  iron, 
iodine  and  arsenic  have  a  certain  effect,  probably  by  acting  on  the 
haematopoiesis. 


GOITRE    IN    CALVES    AND    LAMBS.  453 

CASEOUS    LYMPHADENITIS    OF    THE    SHEEP. 

In  the  sheep  the  lymphatic  glands  are  sometimes  the  seat  of  peculiar 
changes,  which  do  not  appear  to  have  any  marked  effect  on  the  general 
condition.  Thus  a  post-mortem  examination  or  an  examination  of 
animals  in  the  slaughter-house  sometimes  shows  a  certain  number  of 
isolated  or  symmetrical  glands,  such  as  the  mediastinal,  tracheal,  in- 
guinal, pelvic  or  sublumbar  glands,  to  be  greatly  enlarged  and  completely 
degenerated.  The  precrural,  prescapular,  and  popliteal  glands  are  said 
to  be  most  frequently  affected.  Their  contents  are  caseous  and  yellowish, 
enveloped  in  a  fibrous  sheath,  and  show  no  signs  of  peripheral  inflam- 
mation. The  other  organs  and  viscera  may  either  be  healthy  or  exhibit 
caseous  lesions  identical  with  those  found  in  caseous  broncho-pneumonia. 

The  causes  of  this  disease  are  imperfectly  understood,  although 
Cherry  and  ]3ull  (1899,  the  Veterinarian,  Vol.  LXXII.,  No.  860,  p.  523) 
have  isolated  from  the  lesions  an  organism  identical  with  Preisz's 
bacillus  and  with  the  microbe  of  ulcerative  lymphangitis  in  the  horse. 

Norgaard  and  Mohler  (Annual  Report,  United  States  Bureau  of  Agri- 
culture, 1899,  p.  638)  have  studied  the  disease.  In  June,  1897,  Turski, 
at  Danzig,  found  about  150  breeding  ewes,  from  eight  to  twelve  years 
old,  suffering  from  nodules  or  abscesses  the  size  of  a  child's  fist  in  the 
inguinal  and  prescapular  regions.  They  had  been  sold  for  slaughter, 
and  many  were  in  very  poor  condition.  The  disease  occurs  in  Europe, 
Western  America,  South  America,  and  Australia.  Several  thousand 
cases  are  annually  seen  in  the  slaughter-houses  of  the  United  States. 

The  symptoms  generally  escape  notice,  and  it  is  only  by  accident 
that  one  sometimes  detects  marked  enlargement  of  the  lymphatic 
glands  of  the  neck  or  of  the  superficial  inguinal  glands.  The  patients, 
moreover,  may  remain  in  very  good  bodily  condition,  so  that  the 
lesions  are  only  discovered  on  the  meat  being  inspected. 

Having  regard  to  our  imperfect  knowledge  of  this  disease,  it  is 
impossible  to  express  an  opinion  as  to  its  importance  or  treatment. 

GOITRE    IN    CALVES    AND    LAMBS. 

Although  not  strictly  relevant  to  the  foregoing  matter,  a  few  remarks 
may  here  be  made  on  the  subject  of  goitre. 

True  goitre  consists  in  hyperplasia  of  the  follicles  of  the  thyroid 
gland,  with  colloid  change  of  their  contents,  which  are  chiefly  albu- 
minous. The  swelling  is  mainly  due  to  enlargement  of  the  follicles, 
and  is  termed  struma  follicularis.  It  may  attack  the  entire  organ 
or  only  one-half ;  less  frequently  it  is  confined  to  certain  sections. 
Other  varieties  of  goitre  are  recognised,  such  as  fibrous,  varicose  and 
cystic  goitre.  (For  fuller  details  see  Moller  and  Dollar's  "  Regional 
Surgery,"  p.  149.) 


454 


LYMPHATIC   SYSTEM. 


GOITRE    IN    CALVES    AND    LAMBS.  455 

Treatment  by  injection  of  thyroid  juice  or  by  feeding  on  thyvoid 
extract  has  given  better  results  than  drugs. 

The  following  account  of  an  outbreak  in  New  Zealand  is  sum- 
marised from  the  Annual  Report  of  the  Chief  Veterinarian  of  New 
Zealand,  1901:— 

The  calves  affected  were  born  with  enlarged  thyroids.  The  farm  is 
of  rich  alluvial  deposit,  and  rather  below  the  level  of  the  river,  which  it 
borders.  The  land  has  been  in  occupation,  however,  for  many  years, 
and  no  similar  condition  had  been  previously  noted.  At  first,  as  calves 
only  were  affected,  it  was  thought  possibly  to  be  due  to  the  bull,  a  two- 
year-old  animal,  but  when  a  foal  was  born  suffering  from  a  similar  mal- 
formation this  theory  naturally  fell  to  the  ground. 

The  land  had  been  ploughed  with  a  special  plough  20  inches 
deep,  but  this  is  no  uncommon  practice  in  the  island. 

About  the  same  time,  a  similar  disease  was  discovered  affecting 
lambs  at  a  farm  near  Outram.  From  450  ewes,  150  lambs  had  been 
lost,  the  glands  being  enlarged  to  the  size  of  a  cricket  ball.  A  few 
had  been  born  dead,  many  only  lived  a  few  hours,  others  lived  several 
days,  and  a  considerable  number  recovered.  There  was  no  connection, 
directly  or  indirectly,  between  the  two  farms,  they  being  at  least  fifty 
miles  apart.  A  few  of  the  calves  died  or  were  killed,  the  remainder 
recovered,  and  the  foal  grew  rapidly  better.  The  land  on  both  farms 
is  very  similar  in  composition. 

Mr.  Wilkie  states,  from  observation  of  previous  cases  in  lambs,  that 
"  it  appears  to  be  always  associated  with  malnutrition  and  a  condition  of 
ansemia  in  the  parent,  induced  in  most  cases  by  feeding  with  watery, 
innutritious  foods." 

Specimens  were  forwarded,  from  a  calf  and  from  a  lamb,  of  enlarged 
glands.  The  gland  of  the  calf  was  enormously  enlarged,  being  at  least 
twice  the  size  of  an  orange,  dark  in  colour,  flabby  in  consistency,  and 
on  section  a  mucous  material  exuded  copiously  from  the  cut  surface. 
Micro-examination  showed  the  acini  to  be  larger  than  normal,  filled  with 
the  usual  mucous  material,  and  lined  with  cubical  epithelium.  The 
connective  tissue  surrounding  the  alveoli  was,  however,  crowded  with 
round-cells,  so  much  so  that  the  whole  parenchyma  seemed  to  be 
practically  composed  of  these  cells. 

A  specimen  of  an  enlarged  thyroid  from  the  lamb  was  about  the  size 
of  a  sheep's  kidney,  and  very  much  the  same  shape  and  colour.  Sections 
microscopically  examined  showed  a  different  condition  to  that  of  the 
calf's  thj^roid.  Here  the  acini  were  filled  with  epithelial  cells  loosely 
arranged  as  if  the  lining  epithelium  had  been  proliferating  rapidly, 
while  the  connective  tissue  surrounding  the  acini  was  fairly  normal. 
The  section  had  a  somewhat  adenomatous  appearance. 


SECTION    V. 

NERVOUS    SYSTEM. 

CEREBRAL    CONGESTION. 

AccoEDiNG  to  Cruzel,  cerebral  congestion  is  some^Yhat  frequent  in 
working  oxen  subject  to  continued  concussion  from  the  yoke,  especially 
among  animals  working  on  a  rocky  soil.  The  condition  may  also  be 
produced  by  prolonged  exposure  to  the  sun,  as  well  as  by  sudden  and 
intense  cold. 

Passive  cerebral  congestion  by  stasis  may  be  produced  by  any  cause 
markedly  interfering  with  the  return  circulation  (pericarditis  due  to 
foreign  bodies).     Clinically  it  is  of  no  importance. 

The  animals,  previously  in  good  health,  suddenly  apj^ear  comatose. 
They  are  insensible  to  stimulation  of  any  kind,  the  head  is  rested  on  any 
convenient  object  or  is  held  stationary,  the  animal  looks  drowsy,  the 
gait  is  hesitating  or  vacillating,  the  respiration  slow  or  irregular.  Left 
at  liberty,  the  animal  does  not  seem  to  know  where  it  is  going ;  indeed, 
sometimes  it  is  absolutely  blind  and  strikes  against  any  obstacle  in  its 
path,  or  falls  and  suffers  from  epileptiform  convulsions.  The  cranial 
region  is  abnormally  warm.  The  course  of  the  attack  is  rapid,  and 
the  animal  either  dies  in  a  state  of  coma  or  convulsions  or  else  re- 
covers rapidly. 

Diagnosis.  The  diagnosis  is  decidedly  difficult ;  and  the  prognosis 
should  1)6  reserved. 

Treatment  commences  Mith  free  bleeding,  the  amount  of  blood 
drawn  being  proportioned  to  the  animal's  size.  The  sides  of  the  body 
may  then  be  stimulated  and  a  purgative  administered. 

MENINGITIS. 

The  generic  term  "  meningitis  "  includes  all  inflammations  of  the 
arachnoid,  pia  mater  and  internal  surface  of  the  dura  mater. 

These  forms  of  inflammation  occur  in  diseases  such  as  tuberculosis 
and  in  parasitic  diseases  of  the  brain.  Under  other  circumstances,  they 
are  rare,  and  may  be  produced  by  very  varying  causes. 

An   epizootic   cerebro- spinal   meningitis   of   the   bovine  species  has 


MENINGITIS.  457 

also  been  described,  principally  in  Germany,  It  seems  almost  un- 
known in  France,  and  French  literature  contains  no  well-authenticated 
case. 

Furthermore,  an  epizootic  cerebro-spinal  meningitis  of  sheep,  or 
rather  of  lambs,  has  been  described  in  Germany,  in  Italy,  and  in 
France.  These  descriptions  are  all  open  to  many  objections.  It 
seems  that  under  the  term  "cerebro-spinal  meningitis"  have  been 
grouped  cases  of  enzootic  tetanus,  doubtful  cases  of  poisoning,  and 
particularly  cases  of  coenurosis  in  the  first  stage  of  development.  We 
therefore  discard  these  descriptions,  which  differ  too  much  among 
themselves  to  be  of  any  value. 

Causation.  Meningitis  occurs  in  the  ox  and  sheep  as  a  complica- 
tion of  wounds  in  the  cranial  region,  accompanied  by  Assuring  of  the 
bone,  periostitis,  abscess  formation,  etc. 

It  is  also  seen  as  a  complication  of  fractures  of  the  horns,  and  old- 
standing  catarrh  of  the  facial  sinuses.  In  the  sheep  it  follows  parasitic 
catarrh  due  to  the  larvae  of  oestridae. 

The  meningitis  appears,  according  to  circumstances,  in  the  forms  of 
local  meningitis,  anterior  frontal  meningitis,  basilar  meningitis,  etc. 
Finally,  it  may  develop  as  a  complication  of  different  diseases,  such  as 
gangrenous  corj^za,  purulent  infection,  subparotid  abscess,  suppurative 
phlebitis,  suppuration  of  the  e3'e  or  of  the  orbit,  etc. 

Symptoms.  It  is  difficult  to  detect  and  interjjret  the  first  symptoms 
shown,  because  these  chiefly  consist  in  dulness,  want  of  appetite  and 
constipation,  without  any  particular  fever.  At  a  later  stage,  excessive 
excitability  is  produced  by  noises,  by  changes  of  light,  or  by  handling. 
Careful  examination  of  the  patients  shows  a  change  in  their  expression, 
rapidly  followed  by  contraction  and  inequality  of  the  pupils  or  deviation 
of  the  visual  axis  (strabismus,  squinting).  The  pulse  becomes  irregular, 
as  also  the  respiration.  The  appetite  is  entirely  lost,  and  it  is  not 
uncommon  to  note  a  contraction  of  the  muscles  of  the  neck  and  jaws, 
as  well  as  inability  to  move  about  and  sjauptoms  similar  to  those  of 
dropsy  of  the  cerebral  ventricles. 

The  chronic  form  is  rare. 

Lesions.  The  lesions  comprise  local  or  general  hypergemia  and 
exudative  inflammation  of  the  pia  mater  and  arachnoid,  together  with 
the  formation  of  false  membranes  or  of  pus  in  the  subdural  space. 
The  meninges  are  partially  adherent,  and  the  suiDerficial  layers  of  the 
brain  are  also  inflamed  by  contiguity  of  tissue. 

Diagnosis.  The  diagnosis  must  be  based  on  the  disturbance  of 
vision,  movement,  and  appetite,  and  on  the  course  of  the  symptoms, 
as  well  as  on  the  external  signs  in  the  case  of  such  diseases  as  are 
prone  to  become  complicated  with  meningitis. 


458  NERVOUS    SYSTEM. 

Prognosis.  Sooiut  ov  later  tlie  case  is  likely  to  end  fatally,  and 
there  is  no  practical  use  in  treating  the  patient. 

Treatment.  If  in  exceptional  cases  slaughter  is  ol)jected  to,  setons 
and  hlisters  may  be  applied  to  the  poll  or  the  parotid  region,  or  the 
parts  may  be  enveloped  in  ice  bags  or  compresses  of  iced  water 
frequently  renewed. 

ENCEPHALITIS. 

Encephalitis,  i.e.,  inflammation  of  the  cerebral  substance,  is  very 
closely  allied  to  meningitis ;  in  a  great  number  of  cases  meningitis 
and  encephalitis  co-exist.  In  other  cases  encephalitis  may  be  found 
apart  from  meningitis,  and  vice  versa .  Moreover,  many  of  the  symp- 
toms of  meningitis  are  to  be  found  in  cases  of  encephalitis. 

Encephalitis  may  develop  as  a  complication  of  meningitis.  Ence- 
phalitis may  also  follow  abundant  parasitic  infestation,  as  in  coenurosis 
(which  will  be  particularly  studied  as  it  affects  sheep),  or  microbic 
infection,  the  commonest  form  of  which  in  the  ox  is  tuberculosis. 
The  encephalitis  may  be  diffuse  or  circumscribed,  according  to  the 
cause,  while  the  symptoms  are  varied  an-d  numerous.  Very  frequently, 
particularly  in  cases  of  tuberculosis,  encephalitis  assumes  a  chronic 
form. 

Symptoms.  The  earliest  symptoms  are  extremely  difficult  to  detect, 
because  they  are  scarcely  characteristic  and  because  it  is  impossible 
to  ascertain  the  sensations  of  the  animal. 

It  is  only  when  the  disturbances  in  walking,  in  the  eyesight,  in 
swallowing,   etc.,   are  noted  that  suspicion  is  aroused. 

The  symptoms  may  appear  suddenly.  Nevertheless  it  is  beyond 
doubt  that  there  are  certain  slightly  marked  prodromata,  indicated  by 
diminution  of  appetite,  wasting,  and  changes  in  vision.  Soon  afterwards 
occur  other  forms  of  disturbance,  which  may  be  classified  under  the 
heading  of  "  motor,  visual,  nervous,  and  impulsive."  The  patients 
appear  stunned,  their  movements  are  slow  and  hesitating,  they  par- 
tially lose  control  over  their  limbs  and  display  lameness,  with  spasmodic 
movements  of  one  or  two  limbs.  Examination  of  the  joints  shows  no 
injury.  The  lameness  may  simultaneously  affect  two  diagonal  limbs 
or  two  fore  and  two  hind  limbs,  or  even  three  limbs.  This  lameness 
is  of  central  origin. 

The  ocular  disturbance  is  marked  by  diminution  or  loss  of  vision, 
by  strabismus,  or  by  frequent  unconscious  movements  of  the  eyes  and 
eyelids,  and  also  more  particularly  by  inequality,  contraction  or  dila- 
tation of  the  pupils. 

Nervous,  impulsive  disturbance  is  most  readily  noted  when  the 
animals   are   at   liberty.      Even   when   the   sight   remains,  they   seem 


CEREBRAL   TUMOURS.  459 

quite  incapable  of  avoiding  obstacles  or  as  though  absolutely  forced 
to  move  to  the  right  or  left,  etc. 

Attacks  of  giddiness,  moreover,  are  not  unusual  under  the  influence 
of  the  slightest  excitement.  During  such  attacks  the  animals  thrust 
the  head  against  a  wall,  or  they  involuntarily  recoil  or  make  lateral  move- 
ments. In  many  cases  these  vertiginous  attacks  end  by  the  animal 
falling  and  showing  epileptiform  convulsions,  during  which  it  may  die. 

The  symptoms  are  never  the  same  in  two  different  animals,  but 
they  may  easily  be  classed  according  to  the  above  indications.  The 
indications  furnished  by  the  condition  of  the  eyes  and  by  the  peculiar 
impulsive  movements  are  particularly  significant. 

On  the  other  hand,  there  are  modifications  in  breathing  without 
apparent  local  cause,  and  difficulty  or  even  impossibility  of  swallowing, 
etc.,   although  there  exists  no  material   obstacle. 

Diagnosis.  The  condition  is  often  confused  with  meningitis,  and 
the  mistake  is  not  serious,  because  meningitis  and  encephalitis  fre- 
quently accompany  one  another. 

Prognosis.  The  prognosis  must  be  regarded  as  fatal.  The  patients 
very  seldom  recover,  and  there  is  no  reason  for  keeping  them  alive. 

Treatment.  Here,  again,  blisters  may  be  applied  to  the  upper 
extremity  of  the  neck,  or  setons  may  be  passed.  Cooling  applications 
to  the  cranial  region  have  also  been  suggested.  None  of  these 
methods  produces  more  than  a  temporary  palliative  effect. 

CEREBRAL  TUMOURS. 

The  brain  may  be  injured  and  compressed  by  various  tumours  of 
other  than  parasitic  origin.  Such  tumours  may  originate  in  the 
bones,  the  meninges  or  the  choroid  plexus,  or  they  may  simply  be 
due  to  generalisation  of  a  previously  existing  tumour.  Whilst  of 
very  varied  origin  and  nature,  all  tumours  of  the  cranial  cavity  have 
one  common  effect,  viz.,  to  compress  the  brain.  This  continuous 
compression  causes  progressive  atrophy  of  the  brain,  but  its  exist- 
ence is  not  always  suspected,  because  the  lesions  may  not  give  rise 
to  any  marked  symptoms. 

The  hind  portions  of  the  hemispheres  and  the  white  substance 
are  generally  very  tolerant.  The  front  portions,  on  the  other  hand — 
the  frontal  lobes  and  the  grey  substance — resent  compression,  which 
provokes  various  symptoms  in  consequence. 

The  symptoms  of  compression  and  atrophy  of  the  brain  differ 
greatly,  a  fact  which  is  easily  understood,  inasmuch  as  the  seat  of 
the  change  may  varj^,  and  therefore  it  is  possible  only  to  trace  the 
chief  manifestations,  which  suggest  the  existence  of  a  cerebral  tumour. 


400  NEliVOUS    SYSTEM. 

The  general  changes  are  indicated  by  signs  precisely  similar  to 
those  so  common  in  horses  with  dropsy  of  the  ventricles  (general 
depression,  inability  to  back,  long  intervals  between  the  prehension 
of  successive  mouthfuls  of  food,  sudden  cessation  of  mastication,  etc.), 
by  an  impulsive  or  automatic  gait,  and  by  the  assumption  of  strange 
attitudes  (kneeling  down  in  front,  etc.).  When  at  rest  the  animals 
appear  to  be  in  a  state  of  continual  torpor. 

Special  symptoms  sometimes  occur,  which  enable  the  seat  of  the 
injury  to  be  localised  in  more  or  less  exact  fashion.  These  symptoms 
affect  the  vision  (amblyopia,  amaurosis,  strabismus,  nystagmus),  general 
sensibility  (hypercnesthesia,  anaesthesia,  etc.),  and  the  power  of  move- 
ment (total,  partial  or  crossed  hemiplegia,  want  of  co-ordination  of 
movements,  etc.). 

Trifling  stimuli  almost  always  lead  to  marked  and  even  epilepti- 
form attacks. 

The  diagnosis  of  cerebral  tumours  is  very  difficult,  particularly 
when  attempts  are  made  to  indicate  their  exact  seat,  but  that  of 
other  cerebral  lesions  is  somewhat  easier. 

The  prognosis  is  very  grave,  and  in  the  case  of  domestic  animals 
nothing  can  be  done.  In  the  ox  intra-cranial  operations  are  diffi- 
cult, by  reason  of  the  presence  of  the  sinuses  which  obstruct  the 
approach  to  the  brain  cavity  ;  economically  surgical  treatment  is 
seldom  advisable. 

INSOLATION. 

Insolation  is  an  exceptional  accident  in  animals  of  the  bovine, 
ovine,  or  porcine  species.  If  at  liberty  these  animals  move  about, 
and  always  seek  shelter  when  the  sun  is  fierce.  If,  on  the  con- 
trary, they  are  harnessed  and  kept  standing  for  long,  exposed  to  the 
full  midday  sun  during  June,  July  or  August,  they  may  suffer  from 
insolation. 

During  the  International  Cattle  Show  attached  to  the  Exhibition 
of  1900  in  Paris,  a  considerable  number  of  cases  of  insolation  occurred 
in  animals  of  one  class,  exposed  to  the  full  midday  sun,  in  an  ill- 
ventilated  spot.  The  other  classes  only  received  sunlight  from  the 
sides,  and  in  them  not  a  single  case  occurred. 

Death  may  follow  in  a  few  hours ;  it  is  difficult  to  say  precisely 
how  it  is  brought  about,  but  it  is  always  accompanied  by  congestion 
of  the  cerebro-spinal  centres  and  general  blood  stasis. 

The  symptoms  of  the  development  of  insolation  occur  very  rapidly. 
In  animals  of  the  bovine  species  there  is  accelerated  respiration,  which 
soon  amounts  to  dyspnoea.  The  mucous  membranes  then  become 
cyanotic.     The  animals  attacked  seem  anxious,  although  not  agitated, 


POST-PARTUM   PARALYSIS — MILK   FEVER — MAMMARY   TOXtEMIA,  ETC.      461 

and  soon  afterwards  the  eyes  water,  the  mucous  membrane  and  the 
hps  of  the  vulva  display  oedematus  infiltration  and  congestion,  and 
areas  of  cutaneous  congestion,  closely  resembling  mud  fever  in  the 
horse,  appear  over  the  mammae.  At  this  stage  the  animals  move  with 
difficulty,  and  show  all  the  symptoms  seen  at  the  outset  of  gan- 
grenous coryza. 

All  these  symptoms  develop  in  one,  two,  or  three  hours,  and  death 
may  follow  if  nothing  is  done.  They  disappear,  however,  as  rapidly 
as  they  appear.  In  an  hour  or  less  we  have  seen  in  some  cases  a 
complete  return  to  the  normal  condition.  Given  the  facts,  the 
diagnosis  is  extremely  easy. 

Treatment.  Treatment  should  be  commenced  by  immediately  re- 
moving the  animal  to  a  cool,  airy,  shady  place.  It  may  then  be 
bled,  and  the  head  and  neck  should  be  freely  drenched  with  cold  water. 
The  symptoms  generally  disappear  as  though  by  magic. 


POSTPARTUM    PARALYSIS-MILK   FEVER-MAMMARY    TOX/EMIA— 
PARTURIENT    APOPLEXY— DROPPING    AFTER   CALVING. 

For  a  great  part  of  the  following  short  account  we  are  indebted  to  an 
excellent  report  by  J.  J.  Eepp,  V.M.D.,  in  the  Journal  of  Coiiip.  Medicine 
and  Vcterinari)  Archives,  September,  1901  :■ — • 

The  word  "fever  "  in  connection  with  the  terminology  of  this  disease 
is  not  very  appropriate,  because  in  the  majority  of  cases  fever  is  not 
present,  but  the  animal  has  a  subnormal  temperature.  The  term  milk 
fever  is  very  misleading  and  indefinite,  as  it  is  also  used  by  the  laity  to 
designate  other  diseases,  such  as  parturient  septicemia  and  the  various 
forms  of  mammitis.  Parturient  paralysis  must  be  clearly  differentiated 
from  parturient  septicaemia,  which  is  a  disease  of  an  entirely  different 
character  and  which  may  occur  in  any  of  the  domestic  species,  whereas 
parturient  paralysis  occurs  only  in  the  cow. 

Distribution.  Parturient  paralysis  occurs  wherever  milch  cows  are 
kept.  It  is  more  prevalent  in  dairy  districts,  because  it  is  the  heavy 
milking  strains  of  cows  that  are  most  subject  to  the  disease. 

Cause.  No  definite  cause  can  be  assigned  for  this  disease.  Schmidt's 
theory  is  that  parturient  paralysis  is  caused  by  the  evolution  in  the  mam- 
mary gland  of  a  poisonous  substance  through  the  over-activity  of  the 
epithelial  cells  of  this  gland  excited  by  the  determination  to  the  udder 
after  birth  of  large  quantities  of  blood  which  was  supplied  to  the  uterus 
and  the  foetus  before  birth,  but  which  now  goes  to  the  udder  because 
of  the  natural  demand  for  milk  secretion.  This  poisonous  substance 
l)eing  carried  in  the  circulation  to  various  parts  of  the  body,  brings  on 
the  symptoms  which  characterise  the  disease.     It  is  well  recognised  that 


4C2  NERVOUS    SYSTEM. 

living  cells  may,  under  certain  circumstances,  produce  poisonous  sub- 
stances. Schmidt's  theory,  therefore,  is  in  accord  with  an  established 
principle. 

Pathogenesis,  or  generation,  of  the  disease.  Parturient  paralysis, 
as  a  rule,  occurs  in  cows  which  give  a  heavy  flow  of  milk  and  which 
are  in  a  high  state  of  nutrition.  It  may  develop  at  any  age,  but  is 
extremely  rare  in  cows  before  they  have  reached  adult  age  and  have 
given  birth  to  several  calves.  It  is  also  rare  in  old  cows.  It  occurs, 
then,  in  cows  which  are  of  middle  age  and  in  the  full  height  of  their 
activity  as  milk  producers.  The  disease  attacks  the  cow  after  she  has 
given  birth  to  a  calf,  usually  within  twenty-four  hours  thereafter,  but  in 
some  cases  not  until  a  week  or  even  a  month  after  parturition.  In  a  few 
cases  the  disease  has  its  incej^tion  a  short  time  before  parturition.  Cows 
which  are  stabled  and  deprived  of  exercise  are  said  to  be  more  prone  to 
the  disease  than  those  which  are  permitted  to  exercise  at  will.  There 
are  many  exceptions  to  this  statement,  although  it  is  the  usual  teaching. 
Further  observation  may  show  that  it  is  not  correct.  In  Iowa  more 
cows  take  this  disease  while  at  pasture  than  in  any  other  circumstance. 
This  doubtless  arises  from  the  fact  that  in  Iowa  cows  are  given  more 
freedom  than  is  customary  in  older  dairy  States.  The  disease  may  arise 
at  any  time  in  the  year,  but,  on  account  of  the  fact  that  spring-time  is 
pre-eminently  the  calving  season,  most  cases  originate  at  this  season. 

Morbid  anatomy.  The  morbid  alterations  are  limited  and  variable, 
and  offer  nothing  characteristic.  The  blood  is  irregularly  distributed, 
a  condition  which  probably  indicates  marked  vasomotor  disturbance 
resulting  from  the  profound  interference  with  the  nervous  functions 
which  accompanies  the  disease.  The  abdominal  organs  are  usually 
filled  with  blood.  The  brain  may  be  aneemic,  cedematous,  easily  torn, 
and  yellowish  in  colour.  In  other  cases  it  shows  hypertemia  of  the 
meninges  and  of  the  brain  substance. 

Symptoms.  The  disease  usually  appears  within  twenty-four  to  forty- 
eight  hours  after  parturition.  In  extreme  cases  it  may  not  occur  until 
two  months  or  even  six  months  after  parturition.  It  may  rarely  occur 
before  birth.  It  usually  follows  an  easy  birth.  At  the  onset  of  the 
disease  the  cow  manifests  some  uneasiness ;  it  moves  about  in  a  rest- 
less manner,  stamps,  strikes  the  abdomen  with  its  hind  legs,  perhaps 
bellows,  grinds  the  teeth,  and  may  have  spasms  of  groups  of  muscles 
or  even  a  general  convulsion.  After  this  period,  which  may  be  un- 
noticed, the  symptoms  of  paralysis  come  on.  The  cow  shows  weakness, 
staggers,  and  at  last  falls.  As  the  paralysis  advances  it  stretches  on 
the  ground,  lying  on  its  side  usually  with  the  neck  bent  to  one  side  so 
as  to  bring  the  nose  into  the  flank  or  the  costal  region.  This  is  the 
characteristic  position  in  parturient  paralysis.     If  the  head  is  brought 


POST-PARTUM    PARALYSIS — MILK    FEVER — MAMMARY    TOX.EMIA,  ETC.      4C3 

into  the  normal  position,  it  at  once  returns  to  the  unnatural  position  in 
which  it  was  found.  The  animal  is  in  a  state  of  partial  or  complete 
unconsciousness,  does  not  respond  to  blows  or  calls,  and  takes  no  note 
of  its  surroundings.  The  eye  is  dull  and  not  sensitive  to  the  finger 
touch,  sunken,  pupil  dilated,  and  the  upper  -lid  is  drooping  ;  the  tongue 
is  paralysed,  saliva  runs  from  the  mouth,  the  pharynx  and  oesophagus 
have  lost  the  power  of  motion,  so  that  the  animal  is  unable  to  swallow  ; 
the  peristalsis  of  the  stomachs  and  intestines  is  in  abeyance,  and  as  a 
result  digestion  is  arrested,  fermentation  sets  in,  and  the  animal  becomes 
tympanitic ;  the  contents  of  the  rectum  and  colon  are  hard  and  dry,  and 
may  be  covered  with  mucus  or  blood,  urination  is  suspended ;  the  os 
uteri  is  almost  invariably  dilated  if  the  disease  occurs  within  a  day  of 
parturition  ;  pulse  small,  often  imperceptible,  60  to  120  per  minute  ; 
temperature,  usually  normal  or  below  normal,  may  be  as  low  as  95° 
Fahr.,  in  some  cases  may  be  as  high  as  105°  Fahr,  Such  a  high 
temperature  probably  does  not  occur  in  a  case  of  pure  parturient  para- 
lysis, but  only  when  there  is  a  complication  of  parturient  septicaemia. 
The  extremities  are  cold.  The  after-birth  is  sometimes  retained.  There 
may  be  accompanying  prolapse  of  the  uterus. 

Course.  Without  treatment,  and,  indeed,  with  most  kinds  of  treat- 
ment which  have  been  applied  in  the  past,  the  disease  usually  runs 
rapidly  to  a  fatal  issue.  It  lasts  two  to  three  days,  and  in  some  cases 
longer,  the  condition  gradually  becoming  more  and  more  aggravated. 
Death  results  from  sudden  failure  of  the  heart  or  brain,  and  is  often 
preceded  by  profuse  diarrhoea.  In  milder  cases  the  cow  may  linger  as 
long  as  two  to  four  weeks  and  then  die  of  pneumonia,  which  results  from 
the  inhalation,  or  introduction  through  attempts  at  medication,  of  foreign 
substances  into  the  lungs  during  the  period  of  paralysis  of  the  pharynx 
and  oesophagus.  If  recovery  occurs,  the  animal  is  entirely  well  in  two 
to  five  days.  In  rare  cases  paralysis  of  the  hind  parts  may  persist  for  a 
long  while. 

Diagnosis.  This  is  made  by  a  study  of  the  history  and  symptoms. 
It  is  comparatively  easy. 

Differential  diagnosis.  It  must  be  distinguished  from  ante-partum 
paralysis,  broken-back,  parturient  septicemia ;  but  one  familiar  with 
the  character  of  these  diseases  will  find  no  ditficulty  in  making  this 
difterentiation. 

Treatment.  This  may  be  considered  under  two  distinct  subdivisions, 
viz.,  preventive  treatment  and  curative  treatment. 

(a)  Prei-cntirc  trcat)itcnt. — By  considering  what  has  been  said  under 
the  head  of  "  generation  of  the  disease,"  one  can  easily  infer  what 
measures  should  be  adopted  to  prevent  the  disease.  Cows  in  the  later 
stage   of   gestation    should   be    fed   moderately,  grain   esi^ecially  being 


464!  NERVOUS   SYSTEM, 

given  sparingly  or  entirely  withheld  ;  the  animals  should  he  given  an 
opportunity  to  take  plenty  of  exercise ;  the  howels  should  be  kept 
in  good  condition  by  the  administration  of  such  salines  as  magnesium 
sulphate,  sodium  chloride,  and  sodium  bicarbonate.  The  after-birth 
should  be  removed  soon  after  parturition  and  several  uterine  douches 
administered. 

(h)  Cttratirc  treatment. — The  older  methods  of  treatment  comprised  : 
warmth  and  friction  to  the  mammary  gland;  the  administration  of 
sedatives,  such  as  opium,  chloral  and  bromide  of  potassium  ;  stimulants, 
including  ammonia,  ether,  turpentine  and  alcohol ;  washing  out  the 
uterus  with  water  or  disinfectant  solutions  ;  the  relief  of  tympany  by 
the  use  of  the  trocar  and  canula  (by  which  instrument  medicines  may 
also  be  injected  directly  into  the  rumen)  ;  the  removal  of  faeces  from  the 
rectum  ;  warm  clothing  of  the  body  and  general  attention  to  the  animal's 
comfort,  and  to  the  teachings  of  hygiene.  For  all  these  widely  diversi- 
fied methods  good  results  have  been  claimed,  and,  we  may  add,  bad  ones 
at  times  recorded,  F,  T.  Harvey  (Cornwall)  estimates  the  average  mor- 
tality at  from  40  to  66  per  cent.,  though  he  claims  for  his  more  recent 
practice  a  lessened  mortality  of  only  20  per  cent. 

Schmidt  does  not  claim  that  his  method  of  treatment  disposes  bodily 
of  the  morbid  condition,  but  that  it  does  measurably  assist  Nature  in  her 
efforts  to  restore  the  animal  to  the  normal  physiological  state.  It  is 
well  known  that  after  the  beginning  of  the  attack  the  animal,  if  left 
to  itself,  rapidly  grows  worse  until  the  crisis  of  the  disease  is  reached, 
at  which  time  death  occurs  or  convalescence  begins,  usually  the  former. 
It  has  been  observed,  however,  that  if  the  treatment  is  applied  within  a 
few  hours  after  the  inception  of  the  disease  its  progress  is  modified  in 
such  a  way  that  convalescence  at  once  begins,  as  a  rule,  and  the  animal 
hastily  recovers  its  health,  usually  within  twelve  hours,  although  in 
extreme  cases  it  may  be  as  late  as  forty-eight  hours.  The  following  is 
an  outline  of  the  plan  of  treatment  of  parturient  paralysis  suggested  by 
Schmidt.  The  operator  should  disinfect  his  hands  and  the  udder  and 
teats  of  the  cow  by  washing  with  a  5  per  cent,  solution  of  carbolic 
acid  or  creolin,  or  a  1^  per  cent,  solution  of  lysol  or  trikresol.  The 
apparatus  needed  for  the  treatment  consists  of  a  small  glass  funnel, 
a  rul)ber  hose  three  feet  long  and  one-eighth  inch  in  calibre  into  which 
the  funnel  fits,  and  an  ordinary  milking  tube  over  which  the  rubber 
hose  fits.  This  apparatus  should  be  sterilised  immediately  before  it 
is  used  by  boiling  or  soaking  in  such  a  solution  as  recommended  for 
washing  the  udder.  Dissolve  from  2  to  2^  drachms  of  potassium 
iodide — the  size  of  the  dose  depending  upon  the  size  of  the  cow 
and  the  character  of  the  attack — in  about  one  quart  of  clean  water 
previously  boiled   to   sterilise   it,  and  allow  the  solution   to  cool  to  a 


POST-PARTUM   PARALYSIS — MILK    FEVER — MAMMARY   TOX.EMIA,  ETC.      465 

little  above  body  temperature,  or  40°  C.  or  104°  Falir.  The  temperature 
may  be  determined  with  the  clinical  thermometer.  Withdraw  all  the 
colostrum  or  milk  from  the  udder.  Then  insert  the  milking  tube,  with 
hose  and  funnel  attached,  into  one  of  the  teats,  elevate  the  funnel  about 
two  feet  above  the  teat  and  slowly  pour  in  one-fourth  of  the  solution, 
allowing  the  funnel  and  hose  to  become  empty  several  times  during  the 
process  in  order  to  permit  the  entrance  of  a  liberal  quantity  of  air. 
Eepeat  this  infusion  with  the  other  three  quarters  of  the  udder.  After 
all  is  introduced,  knead  the  udder  carefully  so  as  to  cause  the  solu- 
tion to  permeate  the  ducts  and  acini  as  much  as  possible. 

As  the  condition  of  the  cow  is  usually  such  as  to  call  for  addi- 
tional treatment,  the  veterinarian  should  not  be  content  with  injecting 
the  potassium  iodide  solution,  but  should  resort  to  any  and  all  other 
measures  which  promise  assistance. 

As  the  cow  is  usually  unable  to  urinate,  the  bladder  will  be  found 
filled  with  urine.  This  should  be  removed  with  the  catheter,  and  its 
removal  accomplished  at  intervals  until  the  recovery  of  the  cow  renders 
this  procedure  no  longer  needful. 

It  may  be  advisable  that  catharsis  be  brought  about.  As  the  cow 
is  usually  unable  to  swallow,  it  is  dangerous  to  attempt  to  give  medi- 
cines by  the  mouth.  This  may  be  done  if  assurance  that  the  cow 
can  swallow  is  obtained.  Some  have  given  medicines  successfully 
through  a  probang  inserted  into  the  stomach.  The  plan  is  feasible. 
Schmidt  says  that  he  usually  resorted  to  an  aloe  powder.  If  this 
is  done  1  ounce  to  1^  ounces  of  aloes  may  be  given.  It  would  seem 
preferable  to  give  the  aloes  in  a  bolus,  capsule,  or  drench.  Some 
have  given  linseed  oil  or  Epsom  salts.  If  the  animal  cannot  swal- 
low and  a  probang  is  not  at  hand,  one  may  administer  IJ  to  2 
grains  of  physostigmine  salicylate  subcutaneously,  repeating  the  dose 
in  about  three  hours  if  purgation  is  not  produced.  Eectal  injec- 
tions should  be  given  at  short  intervals  in  order  to  get  rid  of  the 
accumulation  of  hard,  dry  ffeces  in  the  rectum.  These  injections  may 
l)e  of  linseed  oil,  cottonseed  oil,  or  warm  soap  solution.  Schmidt 
recommends,  also,  enemata  of  sodium  chloride  solution.  Meanwhile 
the  cow  should  be  kept  propped  up  on  the  sternum  by  means  of  bags 
of  straw  or  pieces  of  wood.  If  the  temperature  is  below  normal,  as  it 
usually  is,  the  cow  should  be  thickly  clothed  with  blankets  and  straw 
heaped  up  about  it.  Schmidt  used  powdered  digitalis  given  by  the 
mouth  when  the  heart  was  rapid  and  weak.  It  would  seem  much  better 
in  every  way  to  give  the  tincture  of  digitalis  subcutaneously.  He  has 
also  resorted  to  subcutaneous  injections  of  camphor  and  caffeine.  This 
is  good  treatment.  If  the  cow  does  not  show  marked  improvement 
within   eight   hours    the   potassium  iodide  infusion    may   be   repeated. 

D.C  H  H 


466  NERVOUS    SYSTEM. 

Schmidt  Las  found  that  as  much  as  6  drachms  may  he  injected  into 
the  lulder  without  harm  to  the  cow.  Schmidt,  in  his  first  report,  made 
in  1898,  recorded  50  cases  treated  for  parturient  paralysis  hy  this 
method  with  but  two  deaths  from  the  disease.  There  were,  however, 
only  46  recoveries,  as  two  cows  were  slaughtered  for  beef  during  the 
first  day  of  convalescence.  A  short  time  later  a  report  was  made  by 
Jensen  showing  that  in  Denmark  up  to  that  time  sixty-five  veterinarians 
of  that  country  had  treated  412  cases  by  the  Schmidt  method,  90  per 
cent,  of  which  recovered.  Such  results  seem  to  indicate  this  as  the  treat- 
ment jjar  excellence  for  parturient  paralysis.  It  still  remained  to  secure 
the  introduction  of  this  treatment  into  the  United  States  and  to  deter- 
mine what  results  could  be  obtained.  In  all  166  cases  were  reported  ; 
of  these  166,  119  resulted  in  recovery,  while  47  were  fatal.  Of  the  fatal 
cases,  in  eight  of  the  cows  death  may  be  traced  to  some  complication,  such 
as  prolapse  of  the  uterus,  foreign-body  pneumonia,  etc.  In  these  cases 
the  Schmidt  treatment  cannot  be  said  to  have  failed,  for  it  is  not  in  any 
way  intended  that  it  shall  be  able  to  overcome  such  accidental  conditions. 
If  the  cow  has  recovered  from  its  condition  of  paralysis  as  a  result  of 
the  Schmidt  treatment  far  enough  to  be  out  of  danger  from  that  source 
and  to  promise  recovery,  but  later  falls  a  victim  to  some  complication 
that  is  in  no  measure  a  part  of  parturient  paralysis,  but  only  a  result 
of  that  disease,  it  may  with  justice  be  said  that  the  Schmidt  treatment 
was  a  success  so  far  as  the  malady  against  which  it  was  directed  is  con- 
cerned. Looking  at  the  reports  from  this  generous  point  of  view,  in  127 
cases  out  of  166,  or  76*5  per  cent.,  the  Schmidt  treatment  was  successful 
so  far  as  the  parturient  paralysis  was  concerned. 

In  a  paper  published  in  the  Berliner  Thierarztliclie  Wochensehrift 
in  August,  1902,  Schmidt  reviews  the  results  of  his  treatment  as 
evinced  by  914  patients  treated  by  thirty-one  different  practitioners  : 
884,  or  96"7  per  cent.,  recovered,  twelve  died  and  six  were  slaughtered 
during  the  course  of  the  disease.  Twelve  others  were  slaughtered  at  a 
later  period  in  consequence  of  complications.  Jensen  reported  the 
results  of   1,744   cases. 

Schmidt  also  found  that  the  simple  injection  of  air  was  in  many 
cases  sufficient  to  produce  recovery,  and  subsequent  observation  tends 
to  show  that  the  fluid  injected  is  of  less  importance  than  was  first 
anticipated.  A  large  number  of  unirritating  solutions  may  be  employed. 
Schmidt,  however,  still  counsels  the  use  of  a  quart  of  1  per  cent, 
solution  of  iodide  of  potassium,  in  which  can  be  dissolved  5  grammes 
of  caffein  sodio-salicylate  if  the  heart's  action  is  weak.  About  10 
ounces  of  this  solution  are  injected  into  each  quarter,  and  are  followed 
by  a  liberal  injection  of  air.  The  parts  should  afterwards  be  freely 
massaged. 


C(ENUROSIS    (GID,    STURDY,   TURN-SICK).  467 

CCENUROSIS    (GID,    STURDY,    TURN-SICK). 

Coenurosis  is  a  disease  due  to  invasion  of  the  animal  body  by  em- 
bryos of  larvae  of  the  Tcenia  cwnurus  of  dogs  and  wolves.  These  embryos 
only  develop  freely  in  the  brain  substance  {Coenurus  cerehraUs)  and 
medulla  oblongata.  The  hosts  of  the  larvae  include  the  calf,  sheep,  goat, 
roedeer,  reindeer  and  horse. 

The  disease  was  formerly  erroneously  called  "  turn-sick,"  for  the 
turning  is  only  a  manifestation,  and  even  a  tardy  manifestation,  of 
the  disease,  while  in  addition  it  is  not  invariably  present. 

Ccenurosis  principally  attacks  lambs  of  from  three  to  six  months, 
although  it  occurs  up  to  eighteen  months,  and  sometimes  even  two 
years.  It  is  exceptional,  however,  in  adults.  Similarly  in  the  bovine 
species  it  usually  affects  young  animals  up  to  the  fourth  or  fifth  year. 

Coenurosis  with  diffuse  parasitic  encephalitis  often  remains  unrecog- 
nised, the  animals  being  regarded  as  affected  with  epizootic  meningitis 
of  unknown  cause  or  septic  intoxication,  and  when  they  die  the  owners 
are  ignorant  as  to  the  cause  of  death.  The  stage  corresponding  to  turn- 
sick,  which  is  an  advanced  phase  of  the  disease,  is  only  seen  in  animals 
which  have  been  infested  to  a  slight  extent,  and  in  which  three  or  four 
parasities  only,  sometimes  only  one,  have  attained  the  brain  and  de- 
veloped there.  Such  cases  exhibit  all  the  classic  symptoms  of  turn- 
sick,  viz.,  turning  movements,  heaviness,  vertigo,  etc. 

Causation.  Coenurosis  is  due  solely  to  one  cause,  viz.,  the  inges- 
tion of  eggs  or  embryos  in  feeding  or  drinking. 

The  Tcenia  co'iinrus  lives  in  the  dog,  and  fertilised  segments  are 
passed  with  the  fseces  in  yards,  pastures  and  fields,  and  on  the  margins 
of  roads,  ditches  and  ponds.  Amongst  damp  grass  or  in  water  the  eggs, 
which  contain  more  or  less  well-developed  eral)ryos,  may  retain  their 
vitality  for  several  weeks,  and  when  swallowed  the  erabrj^os  are  set 
at  liberty  in  the  intestine. 

The  six-hooked  embryos  perforate  the  walls  of  the  intestine,  pass 
into  the  blood  stream  or  chyle  ducts,  and  from  these  points  are  carried 
in  all  directions.  Tiiose  which  gain  the  nervous  centres,  the  brain  or 
spinal  cord,  continue  to  develop  ;  the  others,  dispersed  through  diffe- 
rent tissues,  degenerate  and  disappear. 

Experimental  infection  with  these  parasites  shows  that  the  brain  is 
invaded  after  about  a  week's  time.  From  the  twentieth  day  the  presence 
of  embryos  can  easily  be  detected  in  the  superficial  layers  of  the  convo- 
lutions. They  make  their  way  through  tbe  grey  substance,  leaving 
behind  them  greenish-yellow  sinuous  tracts  with  caseous  contents. 

The  cyst  or  finn  undergoing  development  can  be  found  at  the  end  of 
one  of  these  tracts  in  the  form  of  a  little  transparent  bladder,  of  a  size 

H  H    2 


468 


NERVOUS   SYSTEM. 


varying  between  that  of  a  pin's  head  and  that  of  a  lentil  or  a  small 
hazel-nut. 

Later  the  tracts,  with  their  caseous  contents,  disappear,  and  the 
development  of  many  of  the  vesicles  proves  abortive.  At  the  end  of 
a  month  the  vesicles,  continuing  to  develop  regularly,  attain  to  about 
the  size  of  a  pea.  Between  the  fiftieth  and  sixtieth  days  heads  or 
scolices  appear  in  the  interior  of  the  vesicle,  which  then  reaches  the 


Fig.  214. — Brain  of  sliLup.     Cuimrusis  of  the  left  hemisphere. 
(Estrus  larvae  exposed  by  trepanation. 

dimensions  of  a  hazel-nut.  From  this  time  the  vesicles  continue  to 
increase  in  size  until  the  death  of  the  patient.  Usually  they  become  as 
large  as  a  walnut,  or  even  larger,  and  the  interior  contains  hundreds 
of  scolices,  each  showing  a  head. 

The  cystic  phase  only  develops  completely  in  animals  whose  brains 
contain  a  limited  number  of  cysts,  and  in  such  the  signs  of  turn-sick 
are  well  developed.  In  others,  where  the  numbers  are  large  (ten  to 
fifteen  embryos  or  more),  death  occurs  during  the  primary  stage,  usually 
towards  the  end  of  the  first  month,  in  consequence  of  acute  encepha- 
litis and  without  any  of  the  symptoms  of  turn-sick. 

The  number  of  animals  attacked  is  sometimes  enormous.     Moussu 


C(ENUROSIS    (GID,    STURDY,    TURN-SICK). 


469 


has  recorded  cases  where  fifty,  one  hundred,  and  even  four  hundred 
lambs  of  one  flock  were  affected.  The  enormous  mortaHty  m  such  eases 
is  very  apt  to  cause  errors  in  diagnosis.  Coenurosis  occurs  most  fre- 
quently  during  rainy  seasons,  moisture  favouring  the  preservation    of 


Fig.  215. — Skull  of  a  sheep  showing  the  brain  infested  with  a  gid  bladder- 
worm  {Ccenurtts  cerebral  is).      Two-thirds  natural  size. 


the  eggs.  Young  animals  become  infected,  particularly  during  the 
spring  and  autumn,  more  rarely  in  the  summer,  as  prolonged  desicca- 
tion, say  for  a  period  of  twelve  to  fifteen  days,  destroys  the  vitality 
of  the  eggs,  but  animals  may  become  infested  at  any  time  through 
drinking  contaminated  water.  Moussu  has  seen  coenurosis  (acute 
encephalitis)    from  the  last-named    cause    in    the    middle    of    January, 


470 


NERVOUS   SYSTEM. 


Symptoms.  First  phase. — Dissemhiated  encephaUtis. — The  symp- 
toms vary  with  the  phases  of  evohTtion  of  the  parasite  and  of  the  disease 
which  it  causes.  After  the  six-hooked  emhryos  have  i)eiietrated  to  the 
hrain,  the  animals  affected  lose  appetite  and  show  a  certain  degree  of 
dulness,  which  is  all  the  more  marked  inasmuch  as  the  animals  usually 
affected  are  young,  and  therefore  should  appear  hright  and  alert.  Then 
follow  wasting  and  depression  ;  the  animals  remain  stationary  for  whole 


Fig.  216. — An  adult  gid  tapeworm 
{Tcenia  cwmirus).  Natural  size. 
(After  Eailliet.) 


Fig.  217. — Sexually  mature  segment  of 
the  gid  tapeworm  {Tcenia  coenurus). 
cp,  Cirrus  pouch ;  gp,  genital  pore  ;  n, 
nerve ;  ov,  ovary ;  sg,  shell  gland ;  t, 
testicles;  tc,  transverse  canal;  ut, 
uterus ;  v,  vagina ;  vc,  ventral  canal ; 
vd,  vas  deferens  ;  vg,  vitellogene  gland. 
X  20.     (After  Defl'ke.) 


hours  together,  the  head  heing  carried  low  or  inclined  to  one  side.  At 
this  stage  disturbance  in  vision  and  irregularities  in  movement  may 
appear. 

The  eyesight  is  almost  always  affected,  but  the  symptoms  may  vary 
widely.  In  some  cases  the  patients  seem  to  be  absolutely  blind,  and 
strike  against  any  obstacle  in  their  way ;  in  others  the  power  of  vision 
seems  to  be  lost  only  on  one  side.  All  that  can  be  discerned  objectively 
is  an  inequality  in  the  pupils,  together  with  retraction  or  dilatation,  con- 
vergent or  divergent  strabismus,  nystagmus,  etc.     The  humours  of  the 


CCENUROSIS    (GID,    STURDY,   TURN-SICK).  471 

eye  appear  infected,  but  examination  with  the  ophthahiioscope  reveals 
lesions  of  more  or  less  extensive  neuro-retinitis. 

The  visual  disturbance  is  of  central  origin.  The  powers  of  move- 
ment may  be  affected  in  numerous  ways,  which  at  times  are  extremely 
difficult  to  estimate  with  accuracy.  Sometimes  the  gait  is  uncertain, 
inco-ordinated,  and  hesitant ;  at  others  the  animal  shows  lameness  or 
loss  of  control  over  a  front  or  hind  limb,  or  over  two  limbs  simul- 
taneously (either  the  two  front  or  hind  limbs  or  the  diagonal  limbs), 
or  it  may  be  absolutely  unable  to  stand. 

It  walks  obliquely,  or  the  front  or  hind  limbs  collapse ;  or  again, 
it  may  persistently  lie  down,  a  fact  which  makes  the  shepherd  think  it 
is  suffering  from  paralysis.  On  examination,  however,  no  true  indications 
of  paralysis  can  be  found ;  sensation  and  motor  power  are  both  pre- 
served in  a  modified  form. 

Death  is  very  frequent  at   this  stage  of   the  disease ;    the  animals 
eat  little   or   nothing,   re- 
fuse drink,  and  die  of  ex- 
haustion. 

All  this  general  distur- 
bance is  of  central  origin, 
and  is  due  to  disseminated 
parasitic  encephalitis,  but 
up  to  this  point  the  seat  ^^^  2i8._Brain  of  a  lamb  infested  with  young 
of    the    disease   is    not    yet  gidU-Addevworms {Ccenumscerebralis).   Natural 

clearly  apparent.  size.    (After  Leuckart.) 

Second  phase. — Tani- 
skk. — -The  central  symptoms  are  slow  of  development,  and  are  due 
to  the  progressive  growth  of  one  or  two,  more  rarely  three  or  four,  fer- 
tile vesicles.  These  are  the  true  symptoms  of  turn-sick,  and  it  is  only 
after  this  phase  of  the  disease  has  developed  that  the  term  becomes 
appropriate. 

Left  at  liberty,  the  patient  usually  walks  in  a  circle  towards  the  right 
or  left  in  an  impulsive  and  irresponsible  fashion.  Sometimes  it  describes 
a  circle,  always  of  the  same  size.  In  other  cases,  on  the  contrary,  it 
travels  along  a  spiral  track,  getting  further  from  or  nearer  to  the  centre 
as  the  case  may  be.  The  turning  movement  may  become  so  accentuated 
that  the  animal  appears  to  revolve  as  on  a  pivot,  and  if  it  is  confined  in 
a  field  or  straw-yard  its  legs  become  caught  in  the  litter  and  it  falls  to 
the  ground. 

Attempts  have  been  made  under  these  circumstances  to  discover  the 
exact  point  of  compression,  i.e.,  the  point  at  which  the  cyst  exists,  by 
noting  the  direction  of  the  turning  movement.  The  diagnosis,  however 
arrived  at  in  this  way  is  frequently  illusory,  because  it  is  not  uncommon 


472 


NERVOUS   SYSTEM. 


to  find  two  or  three  vesicles,  and  in  any  case  the  most  important  informa- 
tion in  regard  to  diagnosis  is  to  be  derived  from  the  ocular  symptoms. 

When  only  one  vesicle  exists,  the  turning  movement  usually  occurs 
towards  the  side  on  which  it  is  situated,  and  the  eye  of  the  opposite  side 
is  affected  with  amaurosis. 

If  the  cyst  is  situated  near  the  olfactory  lobes,  the  animal  marches 
with  a  high-stepping  movement  and  the  head  drawn  back  towards  the 


Fig.  219.— sheep's  skull,  the  hind  portion  thin  and  perforated,  due  to  the 
presence  of  gid  bladderworms  {Coenurus  cerebralis).    (After  Dewitz.) 

body.  If  the  cyst  is  in  the  cerebellum  the  animal  is  inca^^able  of 
moving,  because  it  can  no  longer  co-ordinate  its  movements.  Finally, 
if  the  cyst  develops  in  the  occipital  region,  animals  turn  towards  the 
wind,  with  the  neck  raised  and  the  head  extended. 

At  the  moment  when  they  fall  to  the  ground  they  sometimes  have 
epileptiform  convulsions,  grind  their  teeth,  and  salivate  profusely.  In 
a  severe  attack  even  death  may  supervene  at  this  point. 

Coenurosis  of  the  Medulla.  The  embryos  may  develop  in  the 
medulla  oblongata  as  well  as  on  the  brain  itself.  Compression  and 
atrophy  of  the  medulla  then  give  rise  to  true  paralysis. 

The  animals  exhibit  paralysis  of  the  hind  quarters,  unilateral  paralysis 


CCENUROSIS    (GID,    STURDY,    TURN-SICK). 


473 


only,  or  still  less  marked  signs.     Everything  depends  on  the  degree  of 
development  of  the  cysts. 

Bovine  Animals.  CcienuroBis  in  oxen  is  less  important  than  in  sheep. 
Moreover,  it  very  rarely  affects  a  large  number  of  young  animals  belonging 
to  one  farm.  Loss  of  appetite,  dulness  and  depression  are  the  earliest 
indications,  as  in  sheep.  The  gaze  seems  fixed,  the  neck  is  held  stifiliy 
and  almost  rigidly,  the  animal  shows  a  tendency  to  vertigo,  pushes  its 
head  against  a  wall,  or  leans  the  head  or  neck  on  the  manger  or  trough. 

Inequality  in  the  size  of  the  pupils,  amaurosis,  hesitating  and  inco- 
ordinated  movements  may  also  be  seen  developed  in  different  degrees. 
The  animals  have  the  appearance  of  horses  suffering  from  "  iininohiUtc  " — 
that  is,  the  very  peculiar  general  condition  produced  by  dropsy  of  the  brain 
ventricles,  or  from  encephalitis.  They  forget  to  eat  or  do  not  attempt 
to  chew  unless  handfuls  of  food  are  thrust 
between  the  molars ;  they  plunge  the  muzzle 
into  a  bucketful  of  water  and  do  not  drink, 
etc.  They  take  little  notice  of  what  passes 
around  them,  although  they  may  become 
greatly  excited  if  an  attempt  is  made  to  move 
them,  to  give  them  medicine  from  a  bottle,  or 
to  set  them  at  liberty,  etc.  Such  attacks  of 
excitement  often  end  in  vertigo  and  in  the 
animals  falling  to  the  ground  and  showing 
epileptiform  movements.  All  these  symj)- 
toms  may  occur  with  extraordinary  variations, 
due  in  reality  to  the  peculiar  position  which 
the  coenurus  occupies. 

Second  phase.  If  set  at  liberty  during  the  first  phase  of  the  disease, 
the  animal's  gait  appears  only  slightly  disordered,  but  when  a  single 
vesicle  has  become  well  developed  in  one  of  the  hemispheres  (and  this  is 
usually  the  case  with  oxen),  the  symptoms  of  turn-sick  appear  as  in 
sheep,  and  are  equally  varied.  The  patients  seem  impelled  to  move  in 
a  given  direction,  whatever  obstacles  may  be  in  their  way.  It  is  not 
at  all  uncommon  to  see  them  thrusting  their  heads  against  walls  or 
trees,  falling  into  ponds  or  ditches,  or  attempting  to  force  their  way 
through  blind  alleys  between  hay  or  straw  stacks. 

After  the  cyst  develops  in  the  cerebellum,  the  animals  are  soon 
unable  to  move.  They  may  be  able  to  stand  in  one  position,  l)ut  on 
any  attempt  to  move  they  fall. 

Lesions.  The  lesions  develop  successively  from  the  moment  the  em- 
bryos arrive  in  the  mass  of  the  brain.  At  first  the  six-hooked  embryos 
only  excite  a  slight  disseminated  encephalitis.  Their  course  through  the 
brain  is  marked  by  short,  greyish-green  caseous  tracts,  the  thickness  of 


FiCx.  220.— An  isolated  gid 
bladderworm  [Coenurus 
cerehraUs),  showing  the 
heads.    (After  EailHet.) 


474  NERVOUS   SYSTEM. 

a  needle,  which  are  readily  discoverable  in  the  superficial  layers.  Later 
these  caseous  deposits  become  absorbed,  the  lesions  of  disseminated  en- 
cephalitis diminish  and  disappear,  while  a  certain  number  of  vesicles  after 
partial  development  undergo  atrophy  and  disappear.  Before  long  nothing 
remains  but  local  atrophic  encephalitis  caused  by  the  development  of  the 
vesicles,  and  from  this  time  the  central  symptoms  begin  to  appear. 

Diagnosis.  When  the  turning  movement  has  developed  the  diagnosis 
is  generally  easy,  but  it  is  more  difficult  during  the  first  period,  when 
encephalitis  alone  exists;  or  at  least,  it  is  very  difficult  at  this  period  to 
discover  whether  the  symptoms  are  attributable  to  encephalitis,  meningo- 
encephalitis, eoenurosis,  tuberculosis,  or  to  some  injury. 

Prognosis.     The  prognosis  is  grave,  and  very  few  animals  recover. 


Fig.  221. — Diagrammatic  section  of  a  gid  bladderworm  {Coenurus  cerebralis). 
a,  Normal  disposition  of  scolex  ;  h,  c,  d,  e,  diagrammatic  drawing  to  show 
the  homology  between  cysticercus  and  coenurus.     (After  Railliet.) 

Ziirn.  estimated  the  cases  of  recovery  in  flocks  at  2  per  cent.  In  these 
cases  the  cysts  degenerate  and  disappear. 

Treatment.  At  the  present  moment  there  is  no  really  practical 
curative   treatment. 

The  best  plan  appears  to  be  to  trephine  the  skull  and  remove  the 
cyst,  provided  its  exact  position  can  previously  be  determined.  That, 
however,  is  the  great  difficulty.  Its  solution  presupposes  a  perfect 
knowledge  of  the  central  nervous  system  and  of  the  real  purport  of 
any  apparent  symptoms. 

On  the  other  hand,  in  sheep  at  least,  the  position  of  the  cyst  must 
always  remain  somewhat  uncertain,  because  there  are  generally  several, 
and  the  symptoms  are  of  a  mixed  character. 


"trembling,"  or  lumbar  prurigo,  in  sheep.  475 

The  only  treatment,  therefore,  which  woukl  he  hkely  to  succeed  is 
difficult  to  carry  out,  and  more  difficult  in  the  ox  than  in  the  sheep  he- 
cause  of  the  great  development  of  the  frontal  sinuses. 

It  has  been  mentioned  that  under  exceptional  circumstances  the 
coenurus,  if  very  superficially  placed,  may  cause  atrophy  of  the  cranial 
wall  in  the  sheep  by  the  outward  pressure  it  exerts,  and  that  the  points 
of  least  resistance  may  be  detected  by  the  touch.  In  such  cases  inter- 
vention is  necessary  and  is  greatly  facilitated;  but  they  must  be  extremely 
rare,  and  Moussu  declares  he  has  never  seen  one. 

Hartenstein  has  suggested  continuous  cooling  of  the  cranium  by 
irrigation  or  by  applications  of  ice,  the  local  lowering  of  temperature 
serving  to  impede  the  development  of  the  coenurus.  This  method 
should  be  tried  in  animals  of  high  value,  and,  if  the  symptoms  have  not 
yet  become  too  alarming,  recovery  is  possible.  On  the  other  hand,  when 
the  symptoms  indicate  the  presence  of  an  old-standing  cyst,  there  is 
little  chance  of  success.  Moreover,  the  treatment  could  not  be  applied 
where  a  large  number  of  animals  are  affected. 

It  is  much  better  to  send  the  animals  to  the  butcher  if  they  are 
in  good  condition.  In  Scotland,  however — particularly  in  Caithness — 
operation  is  said  to  be  frequently  practised  with  success. 

Prophylaxis.  In  well-managed  establishments  it  is  easy  to  avoid 
the  appearance  of  caniurosis. 

The  development  of  this  condition  being  due  to  the  Tcenia  ca'imnis 
of  the  dog,  which  passes  ripe  segments  containing  eggs  with  its  faeces  in 
the  pastures,  the  first  indication  is  to  prevent  the  development  of  this 
taenia  in  sheep  dogs,  sporting  dogs  and  house  dogs,  and  the  sole  pre- 
caution required  is  to  avoid  giving  them  as  food  sheeps'  heads  contain- 
ing the  bladder  worms.  But,  as  despite  these  precautions  they  may 
accidentally  contract  infection  with  Tcenia  cd'iuints  by  eating  the  offal  of 
slaughtered  animals,  it  is  a  wise  precaution  to  administer  to  all  farm 
dogs,  twice  a  year  at  least,  a  dose  of  some  tsenicide. 

They  should  be  starved  and  kept  in  for  twenty-four  hours,  and  should 
then  receive  a  full  dose  of  some  energetic  vermifuge,  such  as  areca  nut, 
kamala,  kousso,  powdered  pomegranate  root,  extract  of  male  fern,  etc., 
followed  by  a  purgative.  The  material  passed  and  the  faeces  should 
be  burned  or  mixed  with  quicklime.  By  these  simple  precautions  the 
losses  which  formerly  proved  so  heavy  may  entirely  be  prevented. 

"TREMBLING,"    OR    LUMBAR    PRURIGO,    IN    SHEER 

The  above  term  is  applied  to  a  disease  peculiar  to  sheep,  and 
characterised  by  neuromuscular  disturbance,  which  always  ends  fatally 
after  a  longer  or  shorter  period. 


476  '  NERVOUS   SYSTEM. 

Symptoms.  Clinically  the  disease  occurs  in  two  forms,  one  termed 
the  convulsive  form,  the  other  the  pruriginous  form.  In  the  convulsive 
form  the  patients  rapidly  lose  appetite,  soon  appear  unable  to  stand,  fall 
on  their  sides,  and  exhibit  spasmodic  contractions  of  certain  groups  of 
muscles.  After  a  time  the  clonic  contractions  may  give  place  to  per- 
sistent rigidity.  The  patients  are  carried  off  rapidly  in  a  week  or  two 
without  other  important  symptoms.  This  disease  appears  to  exhibit 
certain  analogies  with  louping-ill,  but  these  do  not  seem  to  be  recog- 
nised in  France,  where  it  chiefly  occurs. 

In  the  pruriginous  form  the  beginning  of  the  attack  is  obscure,  and 
only  the  she^jherd  is  able  to  note  anything  unusual.  The  animals  move 
in  a  jerky  way,  the  hind  limbs  being  lifted  at  times  after  the  manner  of 
a  horse  sufiering  from  stringhalt.  They  are  excitable,  exhibit  trem])ling 
movements  when  touched,  with  convulsive  movements  of  the  head,  and 
present  an  anxious  and  vacant  appearance.  The  development  of  these 
symptoms,  which  constitute  what  may  be  termed  the  first  phase  of  the 
disease,  is  sometimes  prolonged,  and  in  winter  may  last  from  one  to  two 
months.     In  summer  it  rarely  lasts  longer  than  a  week  or  two. 

At  this  stage  a  special  pathognomonic  symptom  develops,  viz.,  intense 
and  permanent  pruritus  of  the  hind  quarters,  which  causes  the  animals 
to  rub  the  croup  against  any  projecting  objects,  walls,  mangers,  etc. 
They  thrust  themselves  backward  against  the  object,  and  rub  with 
such  violence  that  the  wool  is  torn  away  and  the  skin  itself  often 
excoriated,  although  the  irritability  appears  to  be  in  no  wise  dimin- 
ished thereby.  In  the  fold  the  animals  sometimes  rub  against  one 
another,  making  their  sides  raw,  and  bite  themselves  on  the  croup, 
the  quarters,  and  the  tail. 

When  the  affected  parts  are  touched  with  the  hand,  peculiar  move- 
ments of  the  head  and  the  lips  are  immediately  excited,  similar  in 
character  to  those  caused  by  mange.  Up  to  this  time  the  animals 
continue  to  feed,  but  they  progressively  lose  condition,  become  weak 
in  the  hind  quarters,  and  fail  to  keep  up  with  the  other  animals  in 
the  flock.  Their  gait  becomes  hesitating;  they  move  with  a  trotting 
step  and  appear  semi-ataxic. 

All  these  symptoms  develop  without  fever,  but  become  aggravated 
from  day  to  day,  until  they  end  in  paraplegia  and  death.  This  second 
jDhase  lasts  for  a  period  of  from  two  to  four  months  in  winter. 

Lesions.  No  lesions  can  be  detected  on  a  simple  examination  of  the 
dead  bodies.  Gilbert  has  mentioned  a  change  in  the  blood  ;  Trasbot, 
chronic  inflammation  of  the  pia  mater  and  of  the  lumbo-sacral  portion  of 
the  spinal  cord.  German  writers  have  described  sclerotic  changes  in  the 
posterior  portions  of  the  cord.  Moussu  has  carried  out  a  large  number 
of  examinations,  but  hfis  never  found  these  lesions,  either  on  anatomical 


"TREMBLING,"    OR   LUMBAR   PRURIGO,    IN   SHEEP.  •        477 

or  on  histological  investigation,  and  he  considers  that  they  are  not  by 
any  means  present  in  all  cases. 

Besnoit  and  Morel,  who  carried  out  a  very  remarkable  anatomical 
and  pathological  study  of  the  disease,  used  Nissl's  staining  method,  but 
only  found  very  discrete  changes  in  the  cord  (vacuoles  in  the  motor  cells 
of  the  anterior  horns).  They  found,  however,  significant  lesions  of 
neuritis  in  the  peripheral  nerves. 

Causation.  The  cause  is  as  yet  little  understood,  and  it  is  difficult 
to  prove  how  the  forms  of  neuritis  described  by  Besnoit  are  brought 
about. 

The  disease  was  not  known  in  France  before  the  introduction  of 
Merinos,  and  former  investigators  referred  it  to  heredity,  consanguinity, 
precocity,  and  even  to  sexual  excitement.  German  writers  declare  that 
it  seems  more  particularly  to  attack  rams  and  the  better-bred  varieties. 
In  reality,  the  disease  occurs  in  all  flocks,  and  in  all  kinds  of  sheep 
indiscriminately ;  it  attacks  ewe  lambs  and  young  castrated  lambs 
as  well  as  rams.  Moussu  is  absolutely  of  this  opinion,  and  for  want 
of  more  precise  information  agrees  with  Trasbot,  and,  he  believes,  with 
Besnoit,  that  the  symptoms  shown  may  possibly  be  referred  to  a 
chronic  intoxication. 

Diagnosis.  The  diagnosis  is  difficult  during  the  early  stages,  but 
when  the  pruritus  becomes  manifest  there  can  no  longer  be  room  for 
doubt. 

Cases  of  paraplegia  might  perhaps  be  mistaken  for  paraplegia  due 
to  coenurosis,  but  in  the  latter  case  there  is  no  pruritus. 

Prognosis.  The  prognosis  is  extremely  grave,  observation  having 
shown  that  all  the  patients  die  after  a  longer  or  shorter  time. 

Treatment.  Until  now  treatment  has  proved  absolutely  useless,  and 
it  would  seem  the  best  course  to  slaughter  the  animals  before  wasting 
becomes  marked. 


SECTION    VI. 

DISEASES    OF    THE    PERITONEUM    AND 
ABDOMINAL    CAVITY. 

CHAPTER    I. 

PERITONITIS. 

Peritonitis,  i.e.,  inflammation  of  the  peritoneum,  may  attack  any  of 
the  domesticated  animals.  It  must,  however,  be  regarded  as  an  ahnost 
accidental  and  relatively  infrequent  disease.  It  is  due  to  infection  of 
very  varying  character,  and  from  the  clinical  standpoint  may  assume 
one  of  two  forms — acute  peritonitis  or  chronic  peritonitis. 

ACUTE    PERITONITIS. 

The  micro-organisms  which  produce  peritonitis  have  not  been  the 
subject  of  special  investigation  in  the  domesticated  animals,  though 
the  colon  bacillus  and  streptococci,  so  frequently  found  in  the  female 
genital  tract  after  parturition,  seem  to  be  the  most  frequent  causa- 
tive agents.  Certain  putrefactive  organisms  may  also  bring  about  the 
disease. 

The  peritoneum  may  become  infected,  and  acute  peritonitis  ensue 
under  various  circumstances. 

All  operations  in  which  the  peritoneal  cavity  is  opened,  such  as 
castration  of  the  cow  and  of  the  sow,  laparotomy,  gastrotomy,  enter- 
otomy,  etc.,  may  be  followed  by  acute  peritonitis  if  performed  without 
sufficient  regard  to  aseptic  precautions.  Peritonitis  then  usually 
assumes  an  acute  septic  form. 

Even  simple  puncture  of  the  rumen,  though  usually  quite  harmless 
if  carefully  performed,  may  by  followed  by  local  or  general  peritonitis 
should  food  material  escape  from  the  rumen  and  find  its  way  into  the 
peritoneal  cavity. 

One  of  the  most  frequent  causes  is  infection  from  the  genital  tract 
soon  after  parturition.  Here  the  agents  of  infection  are  not  introduced 
directly  into  the  cavity,  but  find  their  way  there  in  consequence  of  a 


ACUTE   PERITONITIS.  479 

diseased  condition  of  the  mucous  membrane  and  the  uterine  walls. 
Ascending  infections  of  this  character  and  infections  by  contiguity  of 
tissue  may  only  give  rise  to  local  peritonitis,  though  in  too  many 
instances  they  become  generalised. 

Acute  peritonitis  may  follow  infection  from  the  stomach  or  bowel, 
should  a  foreign  body  perforate  the  rumen  or  reticulum  and  pass 
backwards  towards  the  peritoneal  cavity,  or  a  serious  intestinal  inflam- 
mation (enteritis,  invagination,  etc.)  facilitate  the  passage  of  microbes 
through  the  thickness  of  the  intestinal  wall. 

Abscess  of  the  liver,  suppurative  echinococcosis,  renal  infection, 
pyelo-nephritis,  acute  cystitis,  rupture  of  the  bladder,  etc.,  may  in  a 
similar  way  become  complicated  with  acute  peritonitis. 

Finally,  abdominal  wounds  may  cause  interstitial  ruptures  and 
lesions  in  the  serous  membrane,  accompanied  by  local  exudation 
(kicks,  horn-thrusts,  blows  from  cart-poles,  etc.),  and  if  microbic 
agents  are  brought  within  the  region  of  the  lesion  by  the  general 
circulation  or  otherwise,  peritonitis  may  follow. 

Symptoms.  At  first  the  symptoms  are  vague  and  imperfectly 
defined,  and  diagnosis  is  always  very  difficult  during  the  first  few 
days,  except  in  cases  where  there  exists  a  lesion  or  a  condition  pre- 
viously recognised  as  likely  to  become  complicated  with  peritonitis. 

The  early  symptoms  comprise  fever,  loss  of  appetite,  arrest  of 
rumination,  rigors,  constipation,  etc.,  but  these  symptoms  only  at- 
tain full  significance  when  accompanied  by  what  has  been  termed 
"  peritonism." 

The  patient  appears  to  be  suffering  from  tympanites,  as  may  really 
be  the  case,  but  the  tympanites  of  the  rumen  and  gaseous  distension 
of  the  loops  of  bowel  are  not  primary,  and  only  result  from  the  arrest 
of  peristalsis.  The  primary  condition  is  peritonism,  i.e.,  distension  of 
the  peritoneal  cavity,  this  being  indicated  by  a  symmetrical  fulness 
of  the  right  and  left  flanks. 

The  patients  suffer  from  dull  colic,  and  from  this  time  always 
assume  an  attitude  indicating  pain.  They  remain  in  one  position, 
with  the  back  arched,  the  limbs  gathered  together,  and  the  lower 
abdominal  wall  shortened.  The  face  expresses  suffering,  the  respira- 
tion is  short  and  rapid  and  of  the  costal  type,  movement  is  painful 
and  causes  groaning,  and  the  animals  do  not  shrink  when  the  lumbar 
region  is  pressed  upon. 

Palpation  of  the  abdomen  causes  pain,  and  if  practised  at  certain 
points  may  be  followed  by  groaning.  This  method  of  examination, 
however,  gives  no  further  information,  because  the  abdominal  wall 
is  rigid,  tense,  and  as  though  tonically  contracted. 

Percussion  is  followed  by  tympanic  resonance  in  the  right  and  left 


480  PERITONITIS. 

upper  zones,  due  to  accumulation  of  gases  of  fermentation,  and  to 
distension  of  the  peritoneal  cavity  itself.  Towards  the  lower  parts, 
however,  percussion  produces  a  dull  sound.  The  presence  of  liquid 
can  here  be  detected  by  the  manner  in  which  impulses  are  trans- 
mitted, particularly  at  the  period  of  crisis  and  when  much  exudation 
exists. 

Abdominal  auscultation  shows  that  the  digestive  movements  are 
arrested.  Peristaltic  movement  ceases,  and  the  movements  peculiar 
to  the  rumen  and  to  the  progress  of  food  through  the  intestine  are 
absent.     Fermentation  sounds,  however,  can  be  detected. 

The  heart  beats  are  strong,  rapid  and  violent,  and  yet  the  pulse 
remains  feeble,  though  the  artery  is  tense. 

At  a  later  stage,  when  the  disease  becomes  aggravated,  pain  is 
less  acute,  depression  is  extreme,  the  animals  no  longer  even  drink, 
the  abdominal  wall  becomes  relaxed,  and  diarrhoea  is  succeeded  by 
constipation.  Palpation  of  the  abdomen  is  less  painful  and  does  not 
cause  groaning,  but  the  pulse  becomes  feebler,  much  more  frequent, 
imperceptible,  and  at  last  the  animal  dies  from  intoxication  and 
exhaustion,  caused  by  the  fever  and  pain. 

When  peritonitis  is  due  to  rupture  of  the  intestine  or  escape  of 
alimentary  material  from  the  rumen  into  the  peritoneal  cavity,  as 
may  occur  after  puncture  of  the  rumen  or  gastrotomy,  etc.,  fever 
is  not  always  very  marked.  The  temperature  may  even  fall  below 
the  normal  point.  Some  cases  vary  greatly  from  the  type  described 
as  regards  their  development,  but  the  important  features  are  always 
present,  and  the  difierence  is  chiefly  found  in  the  course  of  the  disease. 

Diagnosis.  The  diagnosis  is  rather  difficult,  but  when  there  is 
colic,  together  with  persistent  peritonism,  exaggerated  sensitiveness 
to  palpation  and  arrest  of  the  functions  of  the  digestive  apparatus, 
there  is  little  room  for  doubt. 

Prognosis.     The  prognosis  of  acute  peritonitis  is  very  grave. 

Lesions.  The  lesions  vary  with  the  primary  cause  (traumatism, 
metritis,  suppurative  echinococcosis,  foreign  bodies  escaping  from  the 
digestive  tract  into  the  peritoneal  cavity,  etc.). 

The  parietal  and  visceral  layers  of  the  serous  membrane  are  always 
inflamed,  vascular,  roughened,  dull,  and  in  places  covered  by  vege- 
tations. Between  the  loops  of  intestine  and  in  the  peritoneal  pockets 
there  are  discovered  more  or  less  numerous  and  more  or  less  thickened 
false  membranes,  presenting  the  characteristics  of  the  false  membranes 
seen  in  acute  pleurisy. 

The  liquid  varies  in  quantity  and  in  colour,  being  sometimes  lemon- 
yellow,  sometimes  purulent,  sanguinolent,  or  even  blackish,  and  of 
putrid  odour. 


CHRONIC    PERITONITIS.  481 

The  lesions  may  appear  more  marked  at  a  particular  point,  such  as 
the  uterus,  rumen,  hypochondrium,  etc.,  and  the  intestinal  loops  may 
become  partly  fixed  in  position  by  false  membranes.  In  time  these  false 
membranes  may  solidify  and  undergo  transformation  into  fibrous  tissue. 

Treatment.  Treatment  is  generally  useless  in  cases  where  perito- 
nitis results  from  rupture  of  the  bladder  or  intestine  or  from  eventra- 
tion. Complete  and  perfect  cleansing  of  the  infected  abdominal  cavity 
is  impossible  in  large  animals. 

In  other  cases  the  animals  should  be  left  completely  at  rest,  and 
purgatives  should  be  avoided.  Movement  or  the  administration  of  pur- 
gatives provokes  peristalsis,  and,  as  a  consequence,  almost  inevitably 
leads  to  generalisation  of  a  lesion  which  might  otherwise  have  some 
chance  of  remaining  localised,  as  in  pelvi- peritonitis  and  peritonitis  due 
to  foreign  bodies  issuing  from  the  rumen  or  reticulum.  If  the  move- 
ments of  the  intestinal  loops  disperse  the  septic  liquids  beyond  the 
points  originally  injured,  the  whole  cavity  becomes  inoculated  and 
generalised  peritonitis  is  set  up. 

Emollient  and  diuretic  drinks  containing  opium,  and  oatmeal  or 
linseed  gruels,  have  the  advantage  of  soothing  the  colic  and  preventing 
stagnation  in  the  bowel.  These  should  be  given  from  the  first  and  solid 
food  entirely  avoided. 

The  sides  of  the  abdomen  should  be  mildly  stimulated,  provided  the 
operation  does  not  give  rise  to  undue  pain  and  cause  the  animals  to 
struggle.  Vesicants  are  preferable  to  mustard,  though  mixtures  of 
mustard  and  linseed  meal  may  be  used,  and,  if  found  advantageous, 
can  be  repeated. 

Mercurial  salts,  though  much  used  in  earlier  times,  are  now  entirely 
given  up.  Diuretics,  such  as  bicarbonate  of  potash,  nitrate  of  potash, 
alcohol,  and  acetate  of  ammonia,  should  be  used,  according  to  cir- 
cumstances. 

Aseptic  washing-out  of  the  peritoneal  cavity  would  be  advantageous, 
but  in  large  animals  cannot  easily  be  effected. 


CHRONIC    PERITONITIS. 

Causation.  Chronic  peritonitis  may  occur  as  a  termination  of  the 
acute  form,  but  it  may  also  develop  gradually  as  a  result  of  disease  of 
the  kidney  (pyelo-nephritis),  of  the  uterus  or  ovaries  (chronic  metritis, 
tumour  of  the  ovary),  of  the  liver  (suppurative  echinococcosis),  or  of 
any  other  lesion  in  neighbouring  parts  which  is  capable  of  setting  up 
continued  irritation. 

It  also  accompanies  tuberculosis  of  the  peritoneum,  cancer  of  the 
peritoneum,  chronic  disease  of  the  .bladder,  etc.     Further,  it  appears, 

D.C.  I  I 


482  PEHITONITIS. 

but  more  rarely,  in  certain  chronic  diseases,  such  as  chronic  dysentery 
and  lymphadenitis. 

Lesions.  The  lesions  consist  of  local  thickenings  of  the  peritoneal 
layers,  and  numerous  papilliform  vegetations  scattei'ed  very  irregularly 
over  the  parietal  peritoneum,  mesentery,  epiploon,  etc. 

If  the  disease  has  existed  for  a  long  time,  fibrous  bands  or  solid 
adhesions  may  be  discovered,  connecting  various  parts  of  the  digestive 
apparatus  ^^'ith  one  another,  or  with  the  abdominal  walls. 

Sometimes  the  intestinal  contents  seem  almost  entirely  adherent  to 
the  abdominal  walls. 

The  primary  lesions  of  the  liver,  spleen,  kidneys,  or  genital  organs, 
from  which  the  disease  originated,  are  also  found. 

The  quantity  of  exuded  liquid  varies  greatly ;  sometimes  there  is  a 
great  quantity  of  a  transparent  or  lemon-coloured  liquid,  resembling  that 
of  ascites.  In  other  cases  the  liquid  is  scanty,  and  may  be  confined 
between  layers  of  bowel,  which  are  connected  by  an  inflamed  layer  of 
epiploon. 

These  old-standing  lesions  cause  atrophy  of  the  abdominal  organs, 
contraction  of  the  intestine,  and  sometimes  true  obstruction. 

In  chronic  tuberculous  peritonitis  the  adhesions  between  the  intes- 
tine and  the  abdominal  walls  may  be  enormous.  The  peritoneum  is 
generally  covered  with  great  masses  of  tuberculous  new  growth,  while 
the  mesenteric  and  sublumbar  lymphatic  glands  are  attacked. 

Symptoms.  The  disease  develops  without  marked  fever  or  grave 
interference  with  the  chief  functions,  and  the  first  approach  of  the 
disease  may,  therefore,  easily  be  overlooked.  Chronic  peritonitis, 
moreover,  may  remain  strictly  localised. 

When  the  disease  assumes  the  ascitic  form  the  dominant  sign  is 
readily  detected.  Where  new  membranes  form  the  principal  lesions  the 
symptoms  are  much  less  definite,  and  the  existence  of  disease  is  chiefly 
indicated  by  digestive  disturbance,  such  as  diminished  peristalsis,  the 
occurrence  of  colic,  diarrhoea,  etc. 

It  is  well  to  remember,  however,  that  these  troubles  often  follow  an 
ascitic  stage,  which  may  gradually  disappear  owing  to  the  fluid  l)ecoming 
absorbed.  Even  in  the  fibrous  form,  where  the  intestines  appear  com- 
pletely glued  together  by  adhesions,  the  volume  of  the  abdomen  is 
increased  and  the  belly  is  deformed,  as  in  ascites. 

In  time  patients  suffering  from  primary  lesions  of  an  important 
internal  organ  are  affected  in  their  digestion,  lose  flesh  and  become 
anaemic,  and  finally  cachectic. 

Diagnosis.  The  diagnosis  is  by  no  means  eas}',  particularly  in  the 
fibrous  forms,  owing  to  the  great  difficulty  of  discovering  the  primary 
lesion. 


ASCITES.  483 

Prognosis.  The  prognosis  is  grave,  though  it  must  not  he  regarded 
as  necessarily  fatah  In  cases  resulting  from  genital  diseases,  and  in 
localised  chronic  peritonitis  resulting  from  persistent,  but  not  excessive, 
mechanical  violence,  complete  and  perfect  recovery  may  occur. 

On  the  other  hand,  in  cases  of  chronic  lesions  of  the  liver,  kidneys, 
heart,  etc.,  and  in  tuberculosis,  carcinoma,  etc.,  recovery  cannot  be 
expected. 

Treatment.  Treatment  should  be  directed  towards  combatting  the 
chronic  inflammation.  With  this  object  resort  may  be  had,  when  neces- 
sary, to  persistent  stimulation  of  the  sides  of  the  abdomen,  mild  blisters 
and  mustard  plasters,  or  friction  with  turpentine. 

The  food  should  be  easy  of  digestion,  and  of  first-rate  quality.  The 
most  useful  drugs  comprise  mild,  unirritating  diuretics,  general  stimu- 
lants, and  tonics. 

Animals  affected  with  incurable  lesions  should  not  be  treated. 


ASCITES. 

True  ascites  consists  in  dropsy  of  the  peritoneum,  unaccompanied  by 
inflammation  of  that  membrane,  or  by  the  presence  of  infectious  micro- 
organisms in  the  transuded  liquid.  Properly  speaking,  it  is  not  a  morbid 
entity,  but  only  a  symptom  common  to  several  very  comi:)lex  diseases. 

Causation.  The  diseases  which  produce  it  may  be  set  forth  under 
five  principal  heads  : — 

(1.)  Cardiac  affections  in  general,  particularly  chronic  lesions  of  the 
heart,  interfering  with  venous  circulation,  and  causing  prolonged  stasis 
of  blood  in  an  organ  or  tissue. 

(2.)  Pericarditis  due  to  foreign  bodies,  and  the  various  forms  of 
pseudo-pericarditis,  i.e.,  lesions  in  the  neighbourhood  of  the  heart, 
causing  compression  of  that  organ  and  of  its  vessels. 

(3.)  Generally  speaking,  all  lesions  which  interfere  with  the  return 
circulation,  particularly  lesions  of  the  liver  (distomatosis,  echinococcosis, 
and  interstitial  hepatitis).  These  produce  compression  of  the  portal 
vein  or  other  obstacle  to  circulation,  and  the  transudation  is  exclusively 
localised  in  the  abdominal  cavity.  The  connective  tissue  does  not 
become  infiltrated. 

(4.)  Diseases  of  the  kidneys  (nephritis,  pyelo-nei)liritis),  which 
secondarily  produce  cardiac  disturbance. 

(5.)  Gestation,  which  causes  compression  of  certain  digestive  viscera, 
and  of  certain  veins  of  the  pelvic  cavity. 

Ascites  was  formerly  regarded  as  always  forming  a  complication 
either  of  antemia  or  of  hydremia.  We  now  know  that  the  primary 
cause   of   these    three   collections   of    symptoms   (ascites,  anaemia,  and 

II  2 


484  PERITONITIS. 

hydraemia)  is  the  development  of  certain  chronic  wasting  diseases  or 
chronic  lesions  of  the  heart,  liver,  and  kidney,  which  act  and  react  upon 
each  other. 

Symptoms.  True  ascites  is  unaccompanied  hy  fever.  The  condition 
develops  slowly,  insidiously,  and  therefore  escapes  notice  at  first.  Only 
when  the  exuded  liquid  is  present  in  considerable  quantities  is  the 
condition  apparent.  The  symptoms  are  similar  to  those  of  ascites 
following  chronic  peritonitis. 

The  transuded  liquid  progressively  accumulates  in  the  peritoneal 
cavity,  the  lower  portion  of  which  it  distends.  When  the  animal  is 
viewed  from  behind  the  enlargement  appears  symmetrical,  despite  the 
position  of  the  rumen.  The  intestinal  contents  float  on  the  liquid  and 
are  thrust  upwards  towards  the  lumbar  region.  On  palpation,  the  ab- 
dominal cavity  seems  unusually  full,  the  tension  differing  in  proportion 
to  the  quantity  of  liquid.  The  accumulation  of  liquid  may  become  con- 
siderable and  interfere  with  respiration,  circulation,  and  movement. 
Very  marked  anaemia  always  exists,  the  mucous  membranes  are  ex- 
tremely pale,  the  respiration  is  rapid,  the  pulse  feeble,  all  these 
symptoms  being  consequent  on  the  primary  disease  of  the  heart  or 
liver.  Percussion  of  the  lower  part  of  the  belly  produces  a  dull  sound. 
On  the  left  side  this  dulness  often  extends  from  the  linea  alba  as  high 
as  a  horizontal  line,  uniting  the  external  angle  of  the  ilium  and  the 
hypochondriac  circle.  On  the  right  it  is  bounded  by  a  horizontal  line. 
Percussion  or,  better  still,  palpation  provokes  on  one  side  of  the  abdomen 
a  wave  or  impulse  of  the  liquid,  perceptible  to  the  touch  or  even  to 
the  view  at  the  opposite  side. 

Diagnosis.  In  general  diagnosis  is  easy,  thanks  to  the  slowness 
with  which  the  disease  develops. 

Prognosis.  The  prognosis  varies  in  each  case,  more  especially 
according  to  the  more  or  less  marked  debility  of  the  animal.  Ascites  due 
to  gestation  is  usually  of  a  very  simple  character,  but  if  it  is  the  result 
of  pericarditis  produced  by  a  foreign  body,  or  of  nephritis,  the  outlook  is 
very  gloomy  ;  lesions  of  the  kidney  in  particular  showing  little  tendency 
to  recovery.  Finally,  the  prognosis  varies  when  the  -ascites  follows 
disease  of  the  liver,  for  certain  exceptional  cases  have  been  noted  in 
which  an  attack  of  hepatitis  has  led  to  the  disappearance  of  the 
transudate. 

Lesions.  The  lesions  peculiar  to  this  disease  are  ver}^  trifling. 
Transudation  takes  place  without  inflammation  of  the  peritoneum, 
although  the  veins  of  the  abdominal  cavity  are  abnormally  dilated. 
The  abdominal  wall  is  thin  and  distended,  and  the  tissues  are  colour- 
less as  though  soaked  in  water.  The  cavity  is  distended  with  a  clear 
lemon-coloured  albuminous  liquid  free  from  blood  corpuscles. 


PERITONEAL   CYSTICERCOSIS.  485 

Treatment.  The  treatment  must  vary  according  to  circumstances, 
i.e.,  having  regard  to  the  primary  cause.  Ascites  due  to  gestation, 
which  is  always  sUght,  calls  only  for  simple  hygienic  treatment ;  but 
when  the  disease  is  attributable  to  lesions  of  the  heart,  pericarditis,  or 
chronic  affections  of  the  kidney  or  liver,  it  is  generally  incurable  in 
common  with  the  original  lesions  themselves. 

If,  finally,  no  clearly  defined  cause  can  be  detected,  or  if  the  ascites 
is  due  to  chronic  peritonitis,  treatment  should  be  attempted.  The  first 
step  may  consist  in  evacuation  of  the  liquid  for  the  purpose  of  reducing 
the  excessive  pressure  on  the  diaphragm  and  facilitating  respiration. 
For  this  purpose  an  aseptic  puncture  is  made  with  a  fine  trocar  on  the 
right  side  of  the  abdomen  in  the  flank  region,  about  equidistant  from 
the  umbilicus  and  the  loose  flap  of  skin  in  front  of  the  stifle.  The  ab- 
sorption of  liquid  may  afterwards  be  assisted  by  administering  diuretics, 
such  as  digitalis,  bicarbonate  of  potash  or  nitrate  of  potash,  and  by 
giving  lukewarm  drinks,  tonics,  etc.  In  Germany  injections  of  pilo- 
carpine have  been  suggested,  but  it  is  doubtful  whether  they  have 
proved  satisfactory. 

PERITONEAL    CYSTICERCOSIS. 

The  above  name  has  been  given  to  a  parasitic  disease  caused  by  the 
infestation  of  young  animals,  such  as  calves,  lambs  and  young  pigs,  vfiih. 
embryos  of  the  Tfeiiia  marginata  of  the  dog. 

Symptoms.  Peritoneal  cysticercosis  is  often  of  so  mild  a  character, 
and  the  number  of  embryos  which  penetrate  the  body  so  small,  that  in 
the  majority  of  cases  there  are  no  visible  symptoms.  It  is  not  until  the 
meat  comes  to  be  dressed  by  the  butcher  that  little  cysts  {Cysticercus 
tennicollis  are  discovered  in  the  abdominal  cavity. 

Unfortunately,  in  exceptional  cases  it  may  also  happen  that  the 
number  of  embryos  in  the  abdominal  cavity  is  so  great  as  to  produce 
lesions  of  acute  hepatitis,  acute  peritonitis,  and  sometimes  pleurisy. 
These  grave  forms  are  more  common  in  young  pigs  and  lambs. 

The  animals  appear  dull,  feeble,  exhausted  and  without  appetite, 
but  exhibit  marked  thirst,  lose  flesh  and  become  ansemic  in  a  few 
days.  Soon  afterwards  they  show  symptoms  of  acute  peritonitis, 
with  exudation  of  fluid,  and  death  may  follow  in  a  week  or  two. 

In  cases  where  infestation  is  less  marked,  the  animals  may  exhibit 
only  progressive  anaemia,  without  well-developed  symptoms  of  peri- 
tonitis, until  death  occurs. 

Lesions.  On  post-mortem  examination  a  sero-sanguinolent  exuda- 
tion is  seen,  together  with  more  or  less  numerous  false  membranes,  and 
a  varying  number  of  young  cysticerci  floating  freely  in  the  liquid  or  en- 
closed in  the  folds  of  the  mesentery.     The  cystic  vesicles  are  spherical, 


486  PERITONITIS. 

ovoid,  or  elongated,  and  translucid  or  opalescent.  They  are  some 
millimetres  in  diameter,  and  in  some  cases  are  very  numerous,  ranging 
from  a  few  hundreds  up  to  several  thousands,  but  in  others  compara- 
tively few. 

The  liver  shows  signs  of  intense  hepatitis,  caused  by  embryos 
burrowing  into  its  tissue. 

Causation.  The  causes  are  limited  to  a  single  fact,  viz.,  ingestion 
of  the  eggs  of  Tcenia  maniinata,  which  are  spread  over  the  fields  in 
the  excrement  of  dogs  suffering  from  that  parasite. 

Diagnosis.  The  diagnosis  can  only  be  arrived  at  by  a  post-mortem 
examination,  wben  cysticerci  in  various  stages  of  development  are 
discovered. 

Prognosis.  The  prognosis  is  difficult  to  indicate,  because  every- 
thing depends  on  the  intensity  of  the  infestation. 

Treatment.  No  curative  treatment  is  possible,  direct  action  on 
the  developing  parasites  being  impracticable.  Nevertheless,  some 
patients  survive,  and  after  having  shown  grave  general  disturbance 
may  gradually  improve. 

The  only  efficacious  treatment  is  of  a  prophylactic  nature,  as  in 
coenurosis  and  echinococcosis.  Dogs  suffering  from  taenise  should 
periodically  be  treated  and  freed  from  their  parasites. 


CHAPTER     II. 
HERNIA.* 

CONGENITAL    HERNIA. 

PERINEAL    HERNIA    OF    YOUNG    PIGS. 

This  variety  is  very  common  in  young  pigs,  on  account  of  their 
anatomical  peculiarities  and  of  the  persistence  and  enlargement  of  the 
inguinal  canal.  Looi)s  of  intestine,  impelled  hy  their  own  weight, 
accumulate  at  the  lowest  point  and  readily  pass  into  the  canal. 

It  is  usually  when  the  little  pig  begins  to  eat,  i.e.,  a  fortnight  or 
three  weeks  after  birth,  that  the  symptoms  become  plainly  apparent. 

The  hernia  is  indicated  by  a  swelling  which  commences  in  front  of 
the  pubis  and  extends  backwards  behind  the  hind  limbs.  When  the 
herniated  loop  of  intestine  is  examined  by  palpation,  the  presence 
of  liquid  in  it  can  be  detected,  particularly  after  a  meal,  while  a 
characteristic  gurgling  sound  is  heard. 

Diagnosis.  To  confirm  the  diagnosis,  the  animal  is  placed  on  its 
back,  whereupon  reduction  as  a  rule  is  easily  effected.  As  soon  as  the 
animal  rises  again  the  hernia  returns. 

The  prognosis  is  not  grave. 

The  treatment  is  exclusively  surgical,  and  the  hernia  can  be  reduced 
and  castration  performed  at  one  and  the  same  time.  The  animal  being 
placed  on  its  back  and  firmly  held,  an  incision  of  ajbout  2  to  3  inches 
in  length  is  made  in  the  inguinal  region,  dividing  the  skin  and  sub- 
cutaneous connective  tissue  only.  The  vaginal  sheath  is  then  com- 
pletely isolated,  the  hernia  reduced,  and  a  ligature  applied  to  the 
sheath  and  the  spermatic  cord  close  to  the  abdominal  wall.  The 
testicle  is  then  removed. 

If  adhesions  have  been  set  up,  which  is  quite  exceptional,  the  vaginal 
sheath  is  incised  and  the  loop  of  adherent  intestine  liberated,  when  it 
can  readily  be  returned.  The  vaginal  sheath  and  spermatic  cord  are 
then  twisted  as  high  as  the  level  of  the  inguinal  ring  and  tied  with 
catgut.     To  prevent  this  ligature  becoming  displaced,  it  should  be  fixed 

*  For  a  fuller  description  of  herniae  and  their  treatment,  see  Moller  and  Dollar's 
"  Regional  Surgery,"  pp.  263 — 309. 


488  HERNIvE. 

by  passing  a  sterilised  thread  through  it  and  through  the  mass  of 
tissue ;  the  hernial  sac  should  be  divided  immediately  below.  In  order 
to  ensure  greater  security,  it  may  even  be  desirable  to  pass  a  suture 
through  the  margins  of  the  inguinal  ring. 

Umbilical  Hernia. 

Umbilical  hernia  is  less  common  in  young  animals  of  the  bovine, 
ovine  and  porcine  species  than  in  the  foal,  and  when  existing  almost 
always  disappears  at  the  period  of  weaning.  The  rumen  then  assumes 
its  full  development,  the  loops  of  intestine  are  displaced  and  thrust 
towards  the  sublumbar  region,  and  the  hernia  disappears.  The  same 
is  true  of  the  young  pig,  the  development  of  the  stomach  producing 
the  same  favourable  result. 

In  the  rare  cases  where  this  hernia  is  not  reduced  spontaneously,  it 
may  be  necessary  to  utilise  the  methods  so  frequently  employed  in  the 
foal,  and,  despite  the  number  of  these,  there  are  only  two  which  can 
thoroughly  be  relied  on  to  give  good  results. 

In  the  first,  irritants  are  employed. 

Subcutaneous  injections  of  concentrated  solution  of  common  salt, 
^filtered  and  sterilised,  or  10  per  cent,  solution  of  chloride  of  zinc  pro- 
duce enormous  engorgement  of  the  connective  tissue,  which  thrusts 
back  the  herniated  loop  of  intestine  and  later  causes  the  development 
of  very  resistant  fibrous  tissue,  which  prevents  the  hernia  returning. 

To  ensure  this  result,  however,  it  is  indispensable  that  perfect 
asepsis  should  be  observed  in  the  injections,  for  if  germs  are  intro- 
duced severe  suppuration  occurs  at  the  point  of  injection.  The 
injections  are  made  at  four  opposite  spots  in  the  subcutaneous  tissue 
surrounding  the  hernia,  1  to  2  drachms  of  saline  solution  being 
injected  at  each  spot ;  of  the  chloride  of  zinc  solution  half  a  cubic 
centimetre  is  used.  This  method  is  only  of  value  in  small  herniae, 
which  may  sometimes  be  cured  by  the  application  of  sinapisms  alone. 

The  second  method  is  applicable  to  larger  hernise,  and  aims  at 
destroying  the  hernial  sac. 

The  application  of  clams  is  simplest,  and  can  be  recommended. 
The  patient  is  placed  on  its  back,  reduction  is  effected,  the  hernial  sac 
is  drawn  upwards  vertically,  and  the  clams  placed  as  near  the 
abdominal  wall  as  possible,  after  care  has  been  taken  that  no  portion 
of  the  intestine  is  included  in  the  sac.  The  clams  are  kept  in  place 
by  a  suture  passed  through  the  neighbouring  tissues. 

In  other  cases  where  a  radical  cure  is  necessary,  because  of  adhesions 
within  the  hernial  sac,  the  patients  are  similarly  placed  on  their  backs, 
the  hernial  sac  is  opened  aseptically,  the  adherent  parts  liberated,  the 
herniated  portions  of  intestine  reduced,  and  the  hernial  ring  sutured 


ACQUIKED   HERNIA. 


489 


with  sterilised  strong  silk,  the  skin  heing  afterwards  brought  together 
with  silk  sutures  after  removal  of  the  sac  itself.  A  surgical  dressing 
can  then  be  applied  to  the  umbilicus.  The  patients  should  be  carefully 
dieted. 

When  the  hernial  ring  is  large  and  its  lips  widely  dilated,  the  silk 
sutures,   even   when   supported   by   secondary   sutures,  sometimes   cut 
through    the    tissues    and    do    not 
achieve  the  desired  result. 

Degive's  method  (see  "Moller 
and  Dollar's  Eegional  Surgery," 
p.  304)  can  then  be  employed.  The 
hernial  sac  is  opened  under  anti- 
septic precautions,  in  order  to  break 
down  any  existing  adhesions,  and 
the  skin  and  edges  of  the  hernial 
ring  are  transfixed  with  packing 
needles  about  8  inches  long.  Above 
these  is  adjusted  a  clam,  which  is 
closed,  by  means  of  a  screw  and 
firmly  secured.  The  packing  needles 
are  then  replaced  with  horse-shoe 
nails,  the  points  of  which  are  bent 
round.  In  about  a  week  the  ne- 
crotic tissue  falls  away,  and  recovery 
occurs  even  in  severe  cases  in  which 
previous  treatment  had  failed. 


Fig.  2. 


Fig.  222. — Schema  illustrating  Degive's 
operation  for  umbilical  and  ventral 
herniae.  A,  Serous ;  B,  musculo- 
aponeurotic,  and  C,  cutaneous  coats 
of  the  hernia;  D,  the  special  needle 
in  place  ;  EE,  clams  ;  FF,  nails.  The 
three  figures  show  bhe  successive 
stages  of  the  operation. 


ACQUIRED    HERNIA. 

Acquired  or  accidental  hernise 
are  not  serious,  and  only  deserve 
to  be  studied  in  so  far  as  they 
affect  organs  contained  within  the 

abdominal    cavity.      They   may    result    from    violence,    or    may    occur 
without  the  intervention  of  any  external  cause. 

Traumatic  herniae  may  occur  at  any  point  in  the  abdominal  wall. 
Under  the  influence  of  a  violent  blow  from  a  waggon  pole,  a  horn 
thrust,  a  kick,  a  fall,  etc.,  the  muscular  tunic  of  the  abdominal  wall 
is  injured  and  becomes  fissured  in  the  direction  of  its  fibres.  The 
peritoneum  is  rarely  affected.  Being  pushed  outwards  by  the  digestive 
viscera,  however,  the  peritoneum  projects  into  the  muscular  layer, 
distends  it,  separates  the  layers  of  subcutaneous  tissue,  and  finally 
forms  a  distinct  hernia. 


490  HERNLE. 

The  consequent  disturbances  are  more  or  less  marked  and  the 
lesions  more  or  less  variable,  according  to  the  part  ati'ected.  In  the 
lower  region  fissure  of  the  abdominal  wall  affects  the  rectus  abdo- 
minis, obliquus  abdominis  and  transversus  abdominis,  and  on  the  right 
side  gives  rise  to  hernia  of  the  abomasum  or  small  intestine,  on  the 
left  of  the  rumen.  In  the  lateral  regions  muscular  fissures  can  be 
produced  only  in  the  transversus  and  obliquus  abdominis  muscles. 
Hernia  of  the  rumen  is  rare  on  the  left  side.  On  the  right  side  hernia 
of  the  intestine  is  more  readily  produced. 

In  all  cases  where  hernia  is  suspected,  the  hernial  orifice  should  be 
examined.     Its  situation  will  at  once  show  which  organ  is  affected. 

Spontaneous  herniae  are  very  rare  in  the  domesticated  animals. 
They  occur  only  in  aged  animals,  and  various  reasons  have  been  suggested 
to  explain  their  appearance.  Certain  herniae  of  this  character  are  only 
found  in  old  female  animals  which  have  borne  a  considerable  number  of 
young.  Eepeated  gestation  produces  elongation  and  relaxation  of  the 
muscular  fibres  from  the  weight  of  the  foetus  and  its  envelopes.  In  time, 
the  abdominal  walls  become  thinner  and  thinner  under  the  weight  of 
the  viscera,  and  thus  facilitate  the  slow  formation  of  a  hernia.  Certain 
practitioners  consider  that  some  of  these  spontaneous  herniae  are  due 
solely  to  the  pressure  j^roduced  by  the  distended  viscera,  as  for  example 
in  greedy-feeding  animals.  In  such  cases  the  weight  of  the  viscera 
would  cause,  as  in  the  previous  case,  a  certain  degree  of  anaemia  and 
emaciation  of  the  abdominal  muscles. 

These  sj^ontaneous  ventral  herniae  are  due  in  reality  to  changes  in 
the  nutrition  of  the  abdominal  wall,  the  exact  cause  of  which  it  is  diffi- 
cult to  ascertain.  The  elastic  tunic  becomes  atrophied,  and  ceases  to  act 
as  an  automatic  girth ;  the  muscular  wall  gradually  becomes  sclerosed 
from  the  white  line  towards  the  sides,  and  having  lost  its  elasticity 
becomes  distended  and   thinned. 

These  changes  are  not  exclusively  caused  by  old  age,  for  they  may 
be  found  even  in  young  animals. 

Nothing  can  be  done  in  cases  of  spontaneous  herniae.  The  qualities 
originally  pertaining  to  the  abdominal  wall  cannot  be  restored,  and 
treatment  is  confined  to  applying  suspensory  bandages,  and,  where  pos- 
sible, preparing  the  animals  for  slaughter. 

HERNIA    OF    THE    RUMEN. 

Causation.  Hernia  of  the  rumen  is,  as  a  rule,  of  traumatic  origin, 
and  always  occurs  in  the  left  flank,  either  in  the  lower  or  middle  regions. 
Cases  of  spontaneous  hernia  of  the  rumen  have  been  observed  in  very 
old  and  anaemic  animals,  as  well  as  in  females  which  have  borne  many 


HERNIA    OF    THE    RUMEN,  491 

young  and  ^Yhich  have  suffered  from  spontaneous  progressive  hernia  of 
the  uterus. 

Symptoms.  The  symptoms  are  the  same  in  all  herniae.  Imme- 
diately after  the  injury  the  abdominal  organs  show  a  tendency  to  escape  in 
the  direction  of  least  resistance.  A  fold  of  the  rumen  passes  through  the 
muscular  fissure,  and  a  swelling  soon  becomes  visible  externally,  which 
alters  the  contour  of  the  abdomen.  Most  frequently  at  this  time  traces 
of  the  injury  can  be  detected  on  the  surface  of  the  skin,  either  the  linear 
trace  due  to  a  horn  thrust,  the  ill-defined  lesion  due  to  a  kick,  or  what  not. 
There  follows  rapid  swelling,  which  results  from  the  inflammatory  re- 
action due  to  rupture  of  small  vessels  within  the  muscle.  A  certain  amount 
of  sanguineous  exudation  and  of  oedematous  swelling  occurs,  and  may  at 
first  suggest  the  existence  of  an  abscess  of  the  abdominal  wall.  At 
the  same  time  there  is  more  or  less  fever,  which  may  continue  for 
a  few  days,  but  the  swelling  seldom  lasts  very  long ;  in  two  or  three 
days  even,  it  becomes  reabsorbed,  commencing  at  the  upper  part  and 
diminishing  progressively  downwards. 

Henceforth  the  hernia  alone  remains. 

It  is  soft,  compressible,  and  sometimes  susceptible  of  reduction.  On 
palpation,  the  operator  feels  a  rupture  extending  through  the  tunic  and 
the  abdominal  wall,  sometimes  even  through  the  muscular  tissue  of  the 
rumen,  in  cases  where  the  skin  is  neither  perforated  nor  torn  through. 
The  mucous  membrane  of  the  rumen  is  rarely  ruptured. 

Whether  or  not  the  peritoneum  is  injured,  the  rumen  presses  be- 
tween the  lips  of  the  wound,  thrusts  back  the  skin,  and  separates  the  con- 
nective tissue,  thus  setting  up  local  irritation  and  cedematous  swelling. 
The  rumen  may  contract  more  or  less  close  adhesions  with  the  abdo- 
minal wall,  and  even  with  the  subcutaneous  tissues. 

Afterwards,  when  the  exudate  has  been  reabsorbed,  palpation  re- 
veals a  different  condition  of  things.  The  mass  is  uniformly  fluctuating 
or  semi-fluctuating,  and  is  surrounded  at  the  base  by  an  indurated  ring 
of  very  varying  dimensions.  The  final  indication — which,  however,  is 
not  invariably  seen — deserves  attention,  viz.,  the  change  in  volume  of 
the  hernia  at  different  moments,  particularly  during  meals.  This 
change  in  size  only  occurs  if  the  hernial  orifice  is  large. 

In  ca.ses  of  spontaneous  hernia  of  the  rumen,  the  condition  is  not 
fully  established  at  first.  It  is  always  progressive,  and  the  lesion  is 
situated  in  the  lower  abdominal  region.  It  increases  in  size  from  day 
to  day,  from  week  to  week,  whilst  the  animals  lose  appetite  and  flesh. 
Spontaneous  herniae  are  never  accompanied  either  by  exudation,  en- 
gorgement, fever,  or  traces  of  mechanical  injury. 

When  only  slightly  developed,  herniae  do  not  threaten  life,  a  fact 
which   often  prevents  the  owners  troubling  about  them.     Progressive 


492  HERNIA. 

herniae  may  become  of  considerable  size,  and  two  cases  are  recorded  in 
one  of  wbich  the  oj^ening  of  the  hernial  sac  was  13J  inches  in  length 
and  18  inches  in  width,  and  in  the  other  28  inches  in  length  and  24: 
inches  in  width.     The  latter  is  the  largest  ever  recorded. 

Complications.  Complications  are  not  always  grave.  If  the  hernia 
is  little  marked  the  function  of  the  rumen  is  not  greatly  affected  and  its 
rhythmic  contraction  continues.  When  the  original  injury  has  caused 
rupture  of  the  muscular  tissue  of  the  rumen,  and  the  mucous  mem- 
brane has  passed  into  the  opening,  it  may  become  strangulated  and 
gangrenous. 

Finally,  if  the  mucous  membrane  has  been  torn  at  the  same  time 
as  the  muscular  tissue  (which  is  very  uncommon),  alimentary  material 
may  escape  into  the  subcutaneous  connective  tissue,  setting  up  either 
cellulitis  and  death  by  infection,  or  suppuration  ;  abscess'  formation  and 
rupture  towards  the  exterior,  followed  by  a  persistent  sinus ;  or  again 
septic  i^eritonitis,  and  death. 

The  same  results  may  occur  when  the  hernia  is  in  a  very  low  portion 
of  the  abdomen ;  food  accumulates  in  it,  becomes  stagnant  there,  sets  up 
local  irritation  and  inflammation,  and  sometimes  abscess  formation  with 
external  discharge,  followed  by  fistula  of  the  rumen. 

Gastric  fistula  without  secondary  complications  is  compatible  with 
life,  and  even  with  fattening  for  slaughter,  provided  the  peritoneum 
covering  the  rumen  becomes  attached  to  the  opposing  surface  of  peri- 
toneum around  the  perforation.  The  fistula  is  then  surrounded  by  a 
circular  mass  of  fibrous  tissue,  forming  a  kind  of   sleeve. 

Lesions.  The  lesions  are  the  same  in  all  hernicne.  They  consist 
primarily  in  rupture  of  the  abdominal  wall,  and,  later,  of  sero-san- 
guinolent  infiltration  of  the  margins  of  the  wound,  similar  to  that  ac- 
companying the  formation  of  an  abscess.  Hernial  swellings  are  of 
very  varying  size.  Apart  from  cases  similar  to  those  above  described, 
the  swelling  may  be  simply  an  inch  or  two  in  diameter,  or  it  may 
attain  the  dimensions  of  a  hen's  egg  or  even  of  a  man's  fist. 

When  the  abdominal  tunic  only  has  been  ruptured,  as  is  most  fre- 
quently the  case,  the  peritoneum  is  thrust  outwards  and  forms  a  cavity, 
the  hernial  sac.  This  sac  is  absent  when  the  peritoneum  is  ruptured. 
Little  by  little  the  surrounding  connective  tissue  forms  a  pseudo-serous 
hernial  sac.  But,  nevertheless,  in  some  cases  there  may  be  found,  im- 
mediately under  the  skin,  the  mucous  membrane  of  the  rumen  in  a 
state  of  congestion  and  ready  to  become  gangrenous. 
Diagnosis.     Easy  in  all  cases. 

Prognosis.  Aery  variable.  In  the  case  of  small  herniae  situated  in 
the  lateral  regions  of  the  abdomen  the  prognosis  is  not  very  grave.  If, 
however,  the  rupture  is  wide,  and  situated  in  the  lower  portion  of  the 


HERNIA    OF   THE    ABOMASUM.  493 

abdominal  walls  in  a  dependant  position,  the  hernial  swelling  steadily 
grows  in  size  in  consequence  of  the  weight  of  the  food  which  is  constantly 
thrust  in  this  direction  by  the  contraction  of  the  rest  of  the  rumen,  and 
recovery  is  impossible.  The  only  resource  is  to  fatten  the  animals  as 
quickly  as  possible  for  slaughter. 


HERNIA    OF    THE    ABOMASUM. 

Causation.  This  condition  is  due  to  causes  similar  to  those  above 
mentioned,  including  mechanical  violence.  It  is  rare  in  adults,  but 
much  commoner  in  young  animals,  especially  in  sucking  calves,  where 
the  abomasum  is  the  most  highly  developed  digestive  compartment. 

Hernia  of  the  abomasum  is  produced  essentially  and  almost  ex- 
clusively by  horn  thrusts  inflicted  when  calves  attempt  to  suck  cows 
other  than  their  own  mothers. 

Symptoms.  Hernia  of  the  abomasum  always  occupies  a  certain 
position  in  the  lower  part  of  the  right  flank,  or,  rather,  in  the  space 
comprised  between  the  white  line  and  the  lower  part  of  the  circle  of 
the  hypochondrium. 

The  immediate  symptoms  are  similar  to  those  of  hernia  of  the 
rumen.  They  include :  progressive  swelling,  formation  of  a  peripheral 
oedematous  ring,  interstitial  sero-sanguineous  exudation,  which  becomes 
absorbed  after  a  few  days ;  finally,  the  development  of  a  hernia,  formed 
as  a  rule  by  the  larger  curvature  of  the  viscus,  which  is  in  direct  con- 
tact with  the  abdominal  wall. 

The  lesions  are  those  common  to  all  hernia,  and  usually  include 
a  partially  healed  wound. 

Diagnosis.  The  diagnosis  is  easy,  particularly  in  calves,  and  the 
possible  existence  of  the  condition  should  always  be  borne  in  mind  when 
dealing  with  injuries  of  the  right  pre-umbilical  zone.  An  abscess  of 
the  lower  abdominal  wall  may  occur  at  or  near  the  umbilicus  as  a  re- 
sult of  omphalitis  or  umbilical  phlebitis,  but  it  is  readily  distinguished 
from  a  hernia. 

The  prognosis  is  graver  than  in  the  case  of  hernia  of  the  rumen,  for 
the  displacement  of  the  abomasum  interferes  with  its  regular  function. 
The  prognosis  varies,  however,  in  accordance  with  the  size  of  the  hernia. 
If  the  rupture  is  small,  there  is  some  chance  that  the  abomasum,  on 
account  of  its  longitudinal  position,  many  penetrate  but  slightly  into 
the  fissure. 

If,  on  the  other  hand,  the  rupture  is  large,  the  prognosis  becomes 
very  serious.  It  is  sometimes  best  to  slaughter  the  animal,  if  in  good 
condition;  otherwise  an  operation  is  necessary. 


494 


HERNIA    OF    THE    INTESTINE. 

Causation.  This  is  due  to  the  same  cause  as  hernia  of  the  rumen — 
a  blow  which,  while  injuring  the  skin  only  to  a  trifling  extent,  damages 
the  abdominal  walls,  and  even  the  intestine  itself. 

Symptoms.  The  hernia  is  situated  in  the  lower  or  lateral  zone  of 
the  right  flank. 

The  symptoms  present  some  peculiarities.  The  loop  of  intestine 
which  has  passed  through  the  aperture  in  the  abdominal  walls  be- 
comes distended  by  the  accumulation  in  it  of  semi-liquid  alimentary 
material,  and,  acting  by  its  own  weight,  produces  a  hernial  sac,  which 
steadily  grows  in  size.  The  skin  being  very  mobile,  and  the  sub- 
cutaneous connective  tissue  very  loose,  they  readily  yield  and  become 
separated.  The  inflammatory  symptoms  disappear,  and  are  followed 
by  a  swelling  under  the  skin,  which  is  compressible  all  over,  and  can 
readily  be  reduced,  whereupon  it  gives  forth  a  gurgling  noise,  or  a 
sound  as  of  borborj^gmus.  Eeduction  is  easier  when  the  animal  is 
lying  on  its  left  side,  or  on  its  back. 

Complications.  Strangulation  of  the  small  intestine  is  the  only 
serious  complication  in  this  form  of  hernia,  but  it  is  very  dangerous. 
It  occurs  frequently  when  the  rupture  is  somewhat  highly-placed  on  the 
lateral  portion  of  the  abdominal  wall,  because  the  loops  of  intestine 
have  a  tendency  to  descend,  thrusting  away  the  skin  owing  to  the 
weight  of  material  which  they  contain. 

The  partially  digested  food  is  apt  to  accumulate  in  the  herniated 
loop,  and  hernial  engorgement,  the  first  phase  of  strangulated  hernia, 
rapidly  occurs. 

Fermentation  is  set  up  in  the  half-digested  food,  and  putrid  gases 
are  generated.  Thus  the  hernial  sac  becomes  distended,  the  vessels 
are  compressed,  circulation  is  arrested,  and  gangrene  supervenes. 

At  this  time  gurgling  sounds  and  a  certain  degree  of  tympanitic 
resonance  may  be  noted.  These  are  followed  by  all  the  symptoms 
of  intestinal  strangulation— namely,  intense  colic,  which  suddenly  dis- 
appears when  the  intestine  becomes  mortified,  absolute  loss  of  appetite, 
stoppage  of  rumination,  constipation,  suppression  of  defecation,  tym- 
panites, and  peritonitis. 

The  diagnosis  is  comparatively  easy  at  an  early  stage,  owing  to  the 
peculiar  character  of  the  soft  swelling,  which  is  easily  compressible. 
At  first  there  may  be  difficulty  in  distinguishing  it  from  a  collection 
of  serous  fluid,  but  the  facility  with  which  the  swelling  can  be  reduced 
removes  any  doubt. 

The  prognosis  is  always  serious,  on  account  of  possible  complica- 
tions, due  to  strangulation  of  the  herniated  loop.     When  the  hernia  is 


TKEATMENT   OF    HERNIA.  495 

chronic,  reduction  is  much  more  difficult,  there  heing,  as  a  rule,  adhe- 
sions between  the  intestine  and  the  hernial  sac. 

TREATMENT    OF    HERNI.^. 

Numerous  attempts  have  been  made  to  treat  abdominal  hernia  in 
bovine  animals. 

Irritant  and  vesicant  applications  to  the  skin  have  been  recom- 
mended, with  the  object  of  producing  a  large  swelling,  and  thus 
thrusting  back  the  herniated  mass  into  its  proper  position. 

One  of  the  most  popular  of  these  applications  is  nitric  acid  of  a 
strength  of  36^  Baume,  applied  to  the  skin  twice  at  an  interval  of 
ten  days.  Skilfully  used,  it  gives  good  results  in  umbilical  hernia, 
but  its  effects  in  ventral  hernise  are  less  certain.  It  causes  slow 
mortification  of  the  skin,  abundant  subcutaneous  swelling,  and  pro- 
duces an  eschar,  which  separates  in  about  a  fortnight. 

An  ointment  of  yellow  chromate  of  potash  (1  to  8)  has  been  recom- 
mended, and  can  be  applied  two  or  three  times  at  intervals  of  eight  or 
ten  days. 

Bandaging  and  various  forms  of  local  dressing  have  also  been  em- 
ployed from  time  to  time.  Serres  employed  simple  bandages  similar 
to  those  used  in  cases  of  inguinal  or  crural  hernia  in  human  beings. 
These  bandages  have  a  pad,  which  is  applied  over  the  hernial  opening, 
but  their  action  is  strictly  palliative.  They  simply  allow  of  the  animal 
being  kept  a  certain  length  of  time  for  fattening. 

When  the  hernia  has  been  reduced  recourse  may  be  had  to  bandaoes 
saturated  in  melted  pitch,  care  being  taken  to  extend  the  dressing  a  con- 
siderable distance  beyond  the  limits  of  the  hernial  opening.  Successive 
layers  of  bandage  are  superposed  across  and  across,  and,  to  make  the 
dressing  more  solid,  the  pads  may  be  reinforced  with  a  sheet  of  solid 
cardboard.  This  method  only  succeeds  when  the  swelling  is  slight  and 
is  situated  elsewhere  than  in  the  lowest  portions  of  the  abdomen. 

Some  practitioners  prefer  a  cloth  bandage  after  reduction.  The 
bandage  is  ten  to  fifteen  yards  in  length,  and  should  be  considerably 
wider  than  the  greatest  measurement  of  the  hernial  opening.  Such 
bandages  can  easily  be  applied  to  calves,  whose  bodies  are  of  regular 
shape,  but  in  adults,  in  which  the  body  is  of  ovoid  formation,  they 
prove  faulty,  and  tend  to  slide  backwards  or  forwards. 

All  these  measures  are  merely  more  or  less  palliative  and  of  tem- 
porary effect. 

The  only  rational  and  radical  treatment  is  surgical.  This  is  clearly 
indicated  when  the  hernia  is  recent  and  of  small  size.  At  a  later  stage, 
when  fibrous  adhesions  have  formed  between  the  various  organs,  and 
reduction  has   become  difficult,   caution  must  be    observed.      Surgical 


496  HERNIiE. 

treatment  is  always  a  serious  matter,  and  should  only  be  attempted 
in  the  case  of  valuable  breeding  animals,  or  those  which  cannot  be  sold 
for  slaughter. 

Young  animals  are  kept  without  food  for  twenty-four  hours  and 
are  cast  on  the  side  opposite  the  hernia ;  they  can  be  placed  on  the 
right  or  left  side,  or  on  the  back,  as  seems  most  convenient.  The 
site  of  operation  is  disinfected,  and  the  operation  carried  out  with 
aseptic  precautions.  The  skin  covering  the  swelling  is  incised  and, 
the  margins  of  the  hernial  orifice  having  been  examined,  the  sac  is 
isolated.  Next,  an  incision  is  carefully  made,  any  adhesions  which  may 
exist  are  broken  down  and  the  herniated  parts  are  reduced.  It  only 
remains  to  suture  the  wound  with  silk  or  catgut,  bringing  the  lips  of 
the  fissure  together.  Finally  the  skin  wound  is  firmly  united,  and  a 
large  suspensory  bandage  tightly  applied. 

If  the  hernia  is  of  long  standing,  and  is  irreducible  on  account  of 
numerous  adhesions,  operation  may  still  be  attempted.  In  that  case 
the  incision  must  be  an  inch  or  two  longer,  all  adhesions  should  be 
destroyed,  and  the  margins  of  the  orifice  need  to  be  freshened  so  as 
to  insure  their  uniting. 

During  the  days  following  operation,  the  animals  should  have  light 
food,  principally  gruel,  mashes  and  cooked  roots.  But  it  must  be  borne 
in  mind  that  this  operation  is  serious,  and  may  possibly  be  followed  by 

eventration. 

DIAPHRAGMATIC    HERNIA. 

The  term  diaphragmatic  or  mediastinal  hernia  denotes  a  condition 
in  which  certain  of  the  abdominal  viscera  penetrate  into  the  thoracic 
cavity.    This  displacement  may  be  congenital,  acquired,  or  accidental. 

The  accidental  hernise  are  of  traumatic  origin,  and  are  often  caused 
by  fractured  ribs,  which  injure  the  diaphragm.  The  hernia  is  then 
purely  diaphragmatic. 

Congenital  or  acquired  herniae  are  more  frequently  mediastinal ;  they 
occur  exactly  in  the  median  plane  as  a  consequence  of  fissure  of  the 
diaphragm  above  the  ensiform  cartilage,  and  cause  a  separation  between 
the  two  layers  of  serous  membrane  enclosing  the  posterior  mediastinum. 

The  region  immediately  behind  the  diaphragm  in  the  ox  being 
occupied  by  the  large  viscera — namely,  the  anterior  conical  portions 
of  the  rumen,  the  reticulum,  the  omasum,  and  the  liver — diaphragmatic 
or  mediastinal  hernia  is  far  from  being  common,  though  occasionally 
it  may  be  discovered  or  at  least  suspected. 

Causation.  The  causes  of  diaphragmatic  and  mediastinal  hernia 
are  closely  connected  with  injuries  in  the  region  of  the  hypochondrium ; 
with  arrest  in  the  development  of  the  diaphragm  ;  or  with  accidental 
vertical  fissuring  consequent  on  gestation  or  acute  tympanites. 


DIAPHRAGMATIC    HERNIA. 


497 


The  fissure  seems  most  commonly  to  occur  between  the  point  where 
the  cesophagus  passes  through  the  diaphragm  and  the  ensiform  carti- 
lage of  the  sternum,  in  which  case  mediastinal  hernicTS  most  commonly 
supervene.  As,  on  the  other  hand,  the  rumen,  owing  to  its  size,  form 
and  position,  cannot  readily  be  displaced,  the  reticulum  and  omasum 
are  the  viscera  which  most  commonly  pass  into  the  thorax. 

Symptoms.  In  true  accidental  diaphragmatic  hernia  visceral  dis- 
placement only  occurs  on  the  right  side,  and  symptoms  of  this  are 
immediately  apparent.     The  passage  of  the  liver,  reticulum,  or  omasum 


Fig.  228. — Intra-mediastinal  diaphragmatic  hernia  (viewed  in  position  from  the  left 
side).     P,  Lung  ;  C,  heart  (displaced)  ;  D,  diaphragm;  H,  hernial  mass. 

into  the  right  pleural  sac  compresses  the  lung,  causes  attacks  of  dyspnoea 
and  acceleration  of  the  heart's  action. 

Percussion  may  not  reveal  any  important  change,  but  on  auscultation 
digestive  sounds  can  plainly  be  heard  within  the  chest. 

The  symptoms  are  far  from  being  well  defined.  They  may  be  more 
or  less  intense,  and  colic  may  or  may  not  be  present.  Mediastinal 
hernia  (Fig.  223)  appears  to  develop  slowly,  and  it  is  only  by  degrees 
that  the  viscera  become  displaced. 

There  is  then  no  sudden  change,  no  clearly  marked  disturbance, 
but  simply  a  certain  amount  of  digestive  irregularity,  together  with 
loss  of  appetite,  cessation  of  rumination,  slight  indigestion,  and  mode- 
rate tymi^anites.  The  disturbance  is  really  due  to  obstruction  in  the 
alimentary  canal  and  displacement  of  the  reticulum  and  omasum,  so 
that  rumination  and  deglutition  are  affected. 

Very  often  this  condition  may  last  for  weeks,  in  either  a  stationary 

B.C.  K  K 


498  HERNIA. 

or  more  or  less  aggravated  form,  so  that  there  is  an  appearance  of 
chronic  gastro-enteritis,  motor  dyspepsia,  or  chronic  indigestion. 

Though  a  diagnosis  in  this  sense  would  be  correct,  the  atony  of 
the  rumen  is  not  primary,  but  of  mechanical  origin. 

One  indication  is  constantly  present,  which  might  suggest  indi- 
gestion due  to  overloading  of  the  rumen,  and  which  is  also  seen  in 
ulcerative  gastritis,  viz.,  progressive  stasis  of  food  in  the  cavity  of  the 
rumen.  When  the  patients  remain  for  some  time  under  observation, 
this  stasis  becomes  every  day  more  marked,  and,  being  recognised,  the 


Fig.  224. — Schema  of  the  position  of  the  organs  in  the  hernia  represented 
by  Fig.  223.  D,  Diaphragm  ;  FF^,  hver  ;  PZ,  pleura  ;  Fe,  omasum  ;  'Re, 
reticuhim  ;  CC,  abomasum. 

diagnosis  becomes  easier.  Animals  suffering  from  mediastinal  hernia  lose 
condition,  waste  away,  and  in  the  end  may  die  in  a  state  of  cachexia. 

Lesions.  The  lesions  vary  greatly.  In  accidental  diaphragmatic 
hernia  they  are  confined  to  rupture  of  the  diaphragm,  sometimes  of 
the  liver,  and  to  changes  in  the  reticulum  or  omasum. 

In  intra-mediastinal  hernia  the  layers  of  the  mediastinum  form  a 
true  hernial  sac,  and  if  the  lesion  is  of  old  standing  the  displaced  viscera 
may  become  attached  to  it,  compressed,  and  partially  strangulated. 

Diagnosis.  The  diagnosis  is  very  difficult,  at  all  events  in  medi- 
astinal hernia,  and  can  only  be  arrived  at  by  a  process  of  exclusion. 


EVENTRATION.  499 

The  most  significant  .symptom  is  progressive  stasis  of  food  within  the 
rumen,  suggestive  of  some  obstacle  in  the  alimentary  canal. 

Prognosis.  The  prognosis  is  extremely  grave,  because  it  is  im- 
possible to  reduce  the  hernia. 

Treatment.  No  treatment  is  possible.  The  essential  point  is  to 
confirm  the  diagnosis  as  soon  as  possible  and  to  slaughter  the  animal 
while  it  is  yet  in  good  condition. 

EVENTRATION. 

Eventration  belongs  to  the  same  group  of  lesions  as  hernife,  of 
which  it  is  merely  a  more  serious  form.  It  differs  from  them  only  in 
the  fact  that  the  entire  abdominal  wall  is  injured.  The  skin,  muscle, 
and  peritoneum  are  torn,  and  the  digestive  organs  pass  into  direct 
communication  with  the  external  air. 

The  name  eventration  has  also  been  given  to  enormous  subcu- 
taneous abdominal  herniae,  in  which  the  sero-muscular  wall  is  injured 
over  a  large  area  and  the  viscera  become  displaced  and  separate  the 
subcutaneous  tissue  layers  while  at  the  same  time  they  alter  the 
whole  shape  of  the  abdomen. 

Causation.  The  cause  is  always  the  same — some  grave  mechanical 
injury  to  the  abdominal  wall,  producing  an  extensive  perforation.  The 
injury  may  be  due  to  a  horn  thrust  or  to  the  animal  falling  on  some 
sharp- edged  body. 

The  symptoms  are  very  marked.  Through  the  wound,  the  rumen, 
the  abomasum,  or  the  intestine  protrudes  more  or  less.  Generally 
it  is  the  small  intestine  which  becomes  displaced,  because  it  is  the 
most  mobile  of  the  abdominal  viscera.  These  organs  soon  become 
dried  by  contact  with  the  air,  and  may  become  infected,  soiled,  con- 
gested, thickened,  torn,  or  gangrenous.  The  successive  development 
of  these  changes  causes  serious  and  violent  colic,  accompanied  by  ex- 
pulsive efforts ;  the  animals  throw  themselves  on  the  ground,  and 
may  tear  the  mesentery,  the  intestines,  etc.  At  an  advanced  stage 
the  animal  may  stand  motionless,  looking  at  its  viscera.  Death  may 
also  be  caused  in  a  very  short  time  by  the  intense  pain. 

Diagnosis  and  Prognosis.  The  diagnosis  is  evident.  The  prog- 
nosis is  ahvays  very  grave,  although,  of  course,  it  depends  on  the 
condition  of  the  displaced  viscera. 

Treatment.  It  is  often  useless  to  attempt  anything,  and  if  the 
animal  is  in  suitable  condition  it  is  best,  as  a  rule,  to  slaughter  it. 

If  the  accident  is  quite  recent,  and  the  viscera  only  slightly  injured, 
surgical  treatment  may  be  attempted.  With  this  object,  the  displaced 
organs  are  carefully  and  thoroughly  washed  with  lukewarm  boiled  water, 

K  K   2 


500 


HERNIiE. 


or  with    some   iinirritating    disinfectant,   to  guard   against  peritonitis, 
and  are  then  reduced. 

The  abdominal  wound  must  afterwards  be  carefully  sutured.  This 
is  performed  in  two  stages.  The  musculo-serous  layer  is  first  brought 
together  with  catgut,  or  better  still  with  silk,  and  the  skin  joined  by 
means  of  deep  and  closely-placed  stitches.  To  prevent  these  sutures 
being  torn  out,  and  to  support  them,  the  abdomen  is  swathed  in  a 
broad  cloth  bandage,  tightly  applied. 

FISTULA    OF     THE    DIGESTIVE     APPARATUS. 

Fistulas  of  the  digestive  apparatus  are  of  accidental  origin  and  of 
relatively  small  practical  interest.  In  most  cases  they  necessitate 
surgical  and  other  treatment  of  too  delicate  a  kind  and  too  prolonged 


Fig.  225. — Fistula  of  the  rumen. 


a  character  to  Justify  the  necessary  expense.     Their  nature  and  origin 
sufficiently  suggest  the  course  to  be  adopted. 

These  fistulfe  are  divisible  into  two  varieties,  gastric  fistulge  and 
intestinal  fistulse.  Gastric  fistulae  comprise  fistulae  of  the  rumen,  reti- 
culum, and  abomasum.  They  may  be  of  external  origin,  but  in  the 
majority  of  cases  they  are  produced  by  foreign  objects  accidentally 
swallowed  and  eliminated  through  the  medium  of  an  abscess  of  the 
abdominal  walls.  Their  position  and  direction  indicate  their  point  of 
origin.  (Fistulfe  of  the  rumen  appear  on  the  left  side  of  the  reticulum, 
near  the  ensiform  cartilage  and  middle  line ;  those  of  the  abomasum 
on  the  right  side,  near  the  middle  line.)     In  doubtful  cases,  chemical 


FISTUL.E   OF   THE   DIGESTIVE   APPARATUS.  501 

analysis  of  the  liquid  which  escapes  will  afford  valuable  information. 
Acidity  alone  is  a  sufficient  indication  in  fistula  of  the  abomasum. 

Fistulae  of  the  rumen  and  reticulum  are  difficult  to  close  on  account 
of  their  low  position  in  the  abdominal  wall,  but,  if  great  care  is  exer- 
cised, they  may  be  successfully  treated.  Those  of  the  abomasum,  on 
the  contrary,  only  tend  to  increase  in  size,  and  any  surgical  inter- 
ference still  further  favours  the  destructive  action  of  the  gastric  juice. 
As  a  rule,  therefore,  they  cannot  be  treated. 

Fistulfe  of  the  second  variety  comprise  all  intestinal  fistulae.  They 
may  be  either  accidental  or  artificial,  and  they  are  less  grave  than 
gastric  fistula,  because  they  are  rarely  situated  in  the  lower  portions 
of  the  abdomen.  With  time  they  may  become  closed  either  sponta- 
neously or  by  means  of  simple  treatment  tending  to  regulate  the 
passage  of  food  through  the  bowel. 


SECTION    VII. 
GENITO^URINARY    REGIONS. 
DISEASES    OF    THE    URINARY    APPARATUS. 

Symptomatology.  The  urinary  apparatus  comprises  the  organs  of 
secretion  (the  kidneys)  and  those  of  excretion,  (the  ureters,  the  bhidder, 
the  urethra). 

A  thorough  examination  of  the  urinary  apparatus  should  include, 
firstly,  that  of  the  external  organs  (the  sheath,  glans  penis  and  urethra) 
in  the  male,  and,  in  the  female,  the  vulva,  meatus  and  urethra  ; 
secondly,  that  of  the  internal  organs  (the  bladder,  ureters  and  kidneys) 
in  both  sexes. 

To  carry  out  the  external  examination,  the  head  must  first  be  fixed 
and  the  hind  limbs  hobbled.  If  necessary,  the  animal  can  be  attached 
to  the  side  of  a  wall. 

External  examination  comprises  inspection  and  palpation,  which  is 
only  possible  in  males.  Inspection  will  reveal  at  once  the  existence  of 
malformation,  deformity,  traumatic  lesions,  or  tumours  of  the  organs. 

By  palpation  the  sheath  and  glans  penis  can  he  examined,  and  cel- 
lulitis, abscess  formation,  calculi  in  the  urethra,  obstruction  of  the  ex- 
tremity of  the  canal  by  very  fine  gravel,  as  in  the  case  of  sheep,  etc., 
can  be  detected. 

The  inner  margin  of  the  right  kidney  may  also  be  examined  by 
external  palpation,  though  only  in  very  thin  animals.  The  examination 
is  made  from  the  flank  region,  behind  the  last  rib,  in  an  upward  direc- 
tion and  towards  the  right  (Fig.  227).  The  kidney,  attached  under  the 
lumbar  region,  sometimes  extends  back  beyond  the  last  rib,  under  the 
transverse  processes  of  the  lumbar  vertebra.  On  the  left  the  presence 
of  the  rumen  prevents  any  examination. 

In  sheep  this  examination  requires  special  care. 

Examination  of  the  internal  urinary  organs  must  be  made  through 
the  rectum.  It  should  be  undertaken  slowly  and  gently.  In  the  male 
the  hand  detects  the  condition  of  the  organs  contained  within  the  pelvic 
cavity,  the  fulness  or  emptiness  of  the  bladder,  or  the  existence  of  calculi 
within  it.     More  deeply  seated  can  be  felt  the  entire  length  of  the  right 


DISEASES   OF   THE   URINARY   APPARATUS. 


503 


ureter ;  its  state  of  dilatation  can  be  felt,  and  the  existence  of  diverticula 
of  inflammation,  if  any,  can  be  ascertained.  The  left  ureter  cannot 
readily  be  examined,  on  account  of  the  position  of  the  rectum,  except 
as  regards  the  posterior  part,  close  to  the  bladder  and  the  rumen. 


Cp.Vs 


Fig.  226. — Genito-urinary  organs  in  the  male  (pelvic  cavity  exposed).  Cj),  Peritoneal 
cavity  (posterior  cul-de-sac) ;  Vs,  vesicula  seminalis ;  R,  rectum  ;  U,  ureter ;  I^j,  line 
of  insertion  of  the  peritoneum  ;  Cd,  vas  deferens ;  V,  bladder ;  Kgt,  testicular 
artery  ;  Ci,  inguinal  canal  ;  P,  penis ;  Cv,  neck  of  the  bladder ;  Ic,  accelerator 
lU'inae  muscle  ;  Gc,  prostate  gland. 

In  the  abdominal  cavity  the  rectum,  or  rather  the  floating  colon, 
turns  to  the  right,  in  such  a  way  that,  in  spite  of  the  shortness  of  the 
meso-rectum  and  meso-colon,  the  hand  can  be  passed  as  far  as  the  right 
kidney.  It  is,  then,  easy  to  discover  whether  this  organ  is  sensitive  to 
pressure,  hypertrophied,  atrophied,  cystic,  etc.  The  paunch  interferes 
with  examination  on  the  left  side. 


504 


GENITO-UEINARY   REGIONS. 


In  females   the  ureters  and  kidneys  can  be  examined  in  the  same 
\\ay,  but  the  bladder  and  the  canal  of  the  urethra  must  be  reached 


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through  the  vagina.  About  2  or  2^  inches  from  the  vulva  on  the  floor 
of  the  vagina  is  the  entrance  to  the  urethra,  covered  with  a  special  valve. 
The  meatus  becomes  visible  by  separating  the  lips  of  the  vulva  and  the 


DISEASES    OF    THE    URINARY    APPARATUS,  505 

vaginal  walls.  For  this  purpose  a  speculum  ad  hoc  can  advantageously 
be  used.  It  is  clear  that  if  it  is  thought  desirable  to  examine  the 
bladder  through  the  rectum,  which  is  not  absolutely  impossible,  the 
vagina  will  be  interposed  between  the  arm  and  the  urinary  organs,  and 
the  sensations  experienced  will,  therefore,  be  much  less  clearly  defined 
(Fig.  226). 

In  passing  a  catheter  for  the  purpose  of  emptying  the  bladder  the 
end  of  the  sound  should  be  introduced  under  the  valve  of  the  meatus. 
By  slightly  lowering  the  back  end  of  the  sound,  the  front  end  is  lifted 
above  the  cul-de-sac,  and  the  operator  at  the  same  time  pushes  gently 
forwards.  It  is  then  only  necessary  to  lift  the  hand,  and  the  sound 
passes  readily  into  the  urethra  and  the  bladder. 

Examination  of  the  urine  and  even  chemical  analysis  are  of  great 
importance  in  diagnosing  diseases  of  the  urinary  tract. 

From  the  clinical  point  of  view  very  complete  analyses  are  not  neces- 
sary, but  the  tests  for  albumen,  sugar,  bile  pigments  and  indican  are 
absolutely  indispensable ;  and  the  same  is  true  of  microscopic  exami- 
nation for  ascertaining  the  presence  or  absence  of  epithelial  cylinders, 
blood  corpuscles,  pus  corpuscles,  etc.  It  is  important  also  to  note  the 
colour  and  odour  and  the  quantity  passed. 

These  examinations  are  by  no  means  difficult.  Albumen  is  detected 
by  adding  a  few  drops  of  acetic  acid  to  the  urine,  and  heating,  or  by 
adding  nitric  acid  and  Esbach's  liquid.  Esbach's  albumenimeter  is  suf- 
ficiently exact  to  discover  the  approximate  amount  of  albumen  present. 
Sugar  is  detected  by  the  use  of  Fehling's  solution,  bile  pigments  by 
nitric  acid,  and  indican  by  adding  a  few  drops  of  10  per  cent,  chloride  of 
calcium  solution  and  hydrochloric  acid.  Should  indican  be  present  a 
more  or  less  deeply  tinted  indigo  blue  circle  appears,  resulting  from  its 
oxidation. 

Hippuric  acid  is  precipitated  by  pure  hydrochloric  acid. 


CHAPTER     I. 
POLYPI    OF    THE    GLANS    PENIS    AND    SHEATH. 

In  young  animals  the  extremity  of  the  glans  penis  and  the  margins 
of  the  sheath  are  not  infrequently  studded  with  polypi,  soft  swellings  of 
papillomatous  or  verrucous  appearance,  sometimes  of  considerable  size, 
which  interfere  with  micturition,  and  deform  the  glans.  The  existence 
of  these  growths  is  shown  by  very  well  marked  signs — viz.,  difficulty  in 
micturition,  deformity  of  the  sheath,  deviation  of  the  jet  of  urine,  ob- 
struction in  the  passage  of  the  penis,  and  more  or  less  marked  deformity 
of  the  penis  itself. 

These  polypi  are  of  the  same  nature  as  those  so  common  in  dogs, 
viz.,  papillomata. 

The  diagnosis  is  very  easy.  On  digital  examination  the  growths 
are  almost  always  found  at  the  base  of  the  sheath. 

At  an  early  stage  the  prognosis  is  benign,  provided  intervention  is 
promptly  undertaken.  If  the  disease  is  of  old  standing,  or  is  not  treated, 
the  animals  may  become  somewhat  thin.  They  suffer  pain,  caused  by 
retention  of  urine  and  inflammation  of  the  sheath ;  urethritis  may  even 
be  set  up. 

The  treatment  is  fairly  easy,  and  is  exclusively  surgical;  but  as  it 
necessitates  casting  the  animals  the  bladder  should  first  be  examined 
per  rectum,  and  operation  should  never  be  attempted  until  the  bladder 
has  been  emptied  so  as  to  avoid  possible  rupture.  The  animal  being 
fixed  on  its  back,  the  penis  is  withdrawn  from  the  sheath,  and  the 
polypi  can  then  be  snipped  off  with  scissors,  the  wounds  being  slightly 
cauterised  to  arrest  haemorrhage  :  in  the  case  of  the  sheath,  rather  ex- 
tensive wounds  must  sometimes  be  produced ;  these  may  be  sutured. 

To  prevent  the  wounds  afterwards  becoming  infected  and  suppurating, 
the  sheath  should  be  regularly  washed  out  with  an  antiseptic  solution 
and  the  animal  kept  on  a  very  clean  bed. 

INFLAMMATION    OF    THE    SHEATH. 

This  condition  is  much  more  common  in  the  ox  than  in  the  horse  on 
account  of  the  different  anatomical  structure  of  the  parts,  and  the 
methods  of  keeping  and  using  oxen. 


INFLAMMATION  OF  THE  SHEATH.  507 

Causation.  Several  predisposing  causes  undoubtedly  exist.  The 
sheath  is  prolonged  beneath  the  abdomen  to  a  considerable  distance 
beyond  the  glans.  It  is  narrow,  deeply  seated,  and,  during  micturition, 
not  even  the  point  of  the  penis  passes  beyond  it.  The  urine,  therefore, 
soils  the  interior,  or  a  certain  quantity  may  be  retained,  according  to» 
whether  the  orifice  is  more  or  less  obstructed  by  urinary  sediment, 
sebaceous  material,  manure,  or  other  material.  Moreover,  experience 
shows  that  of  all  the  large  ruminants,  those  used  for  outdoor  work  are 
the  most  affected. 

Of  the  occasional  causes,  if  we  except  sebaceous  and  urinary  pro- 
ducts, the  most  important  is  mechanical  violence,  such  as  the  lacera- 
tions or  wounds  produced  by  the  bed-piece  of  the  trevis  when  the  animal 
is  being  shod.  The  working  ox  throws  its  whole  weight  on  this  bed- 
piece,  on  which  it  lies  on  one  side  or  the  other,  according  to  the  foot 
which  is  being  lifted.  The  sheath  is  compressed,  and  if  the  animal  is 
heavy  and  struggles,  the  parts  may  be  abraded  and  torn,  or  the  sheath 
and  even  the  glans  may  be  crushed.  In  less  dangerous  cases  the  con- 
nective tissue  may  be  lacerated  by  the  edge  of  the  bed -piece.  Any 
injury  so  inflicted  is  aggravated  by  dirt  in  the  neighbourhood. 

Symptoms.  The  first  signs  which  attract  attention  are  of  a  general 
character,  and  seldom  very  strongly  marked.  The  animal  shows  slight 
fever,  dryness  of  the  muzzle,  is  restless  and  continually  moves  about,  as 
though  to  get  rid  of  the  pain  it  feels.  The  hind  limbs  are  frequently 
lifted.  In  this  attitude  it  makes  efforts  to  urinate,  but  urine  is  passed 
very  slowly,  and  the  act  seems  painful ;  then,  later  on,  the  appetite 
diminishes,  rumination  is  suspended,  and,  as  in  all  intense  forms  of 
cellulitis,  complications  may  occur. 

The  local  symptoms  are  more  suggestive.  The  slowness  and  diffi- 
culty with  which  urine  is  passed  at  once  attracts  attention  to  the 
diseased  parts.  Examination  immediately  reveals  extreme  sensitiveness 
of  the  sheath,  although  as  yet  there  is  only  slight  engorgement.  At  a 
later  stage  a  large  swelling  develops  and  extends  along  the  abdominal 
wall  on  either  side,  sometimes  upwards  into  the  groin.  In  certain  cases 
the  sheath  may  be  totally  obstructed  by  sebaceous  and  inflammatory 
material,  and  in  the  absence  of  surgical  assistance  the  bladder  may 
become  ruptured. 

Inflammation  most  frequently  ends  in  the  tardy  formation  of  an 
abscess,  which  shows  little  tendency  to  open  spontaneously.  It  is 
usually  accompanied  by  gangrene  and  by  mortification  of  a  mass  of 
skin  and  subcutaneous  tissue,  sometimes  of  portions  of  the  abdominal 
tunic.  Such  grave  complications  may  even  lead  to  the  opening  of 
an  artery,  and  to  fatal  hemorrhage. 

All  tiiese  symptoms  develop  comparatively  slowly.  Abscesses  scarcely 


508  URINARY   APPARATUS. 

ever  appear  before  the  twelfth  or  fifteenth  day,  but  when  the  disease 
is  not  treated  it  may  continue  as  long  as  five  or  six  months.  On 
the  other  hand,  resolution  is  the  ordinary  termination  under  suitable 
treatment. 

Diagnosis..  The  diagnosis  is  easy  when,  the  exact  facts  can  be 
ascertained.  The  difficulty  in  micturition  is  the  chief  indication.  At 
a  later  stage,  local  swelling  and  acute  sensitiveness  are  characteristic. 

Prognosis.  The  prognosis  is  grave,  having  regard  to  possible  com- 
plications and  the  chronic  character  which  the  inflammation  tends  to 
assume. 

Treatment.  When  the  sheath  is  filled  with  sebaceous  material  or 
foreign  substances  it  may  be  necessary  to  cleanse  it  daily  with  mild 
antiseptic  injections.  Some  practitioners  recommend  laying  open  the 
external  orifice,  an  operation  which  may  be  performed  in  the  stand- 
ing position.  This,  however,  is  not  without  danger,  and  infection 
may  easily  occur. 

When  the  subcutaneous  connective  tissue  surrounding  the  sheath 
and  the  glans  penis  is  infiltrated  and  inflamed,  the  inflammatory 
swelling  must  be  examined  every  day,  so  as  to  detect  the  abscesses  as 
early  as  possible,  and  open  them  without  delay.  Under  some  circum- 
stances deep  firing  in  points  produces  very  favourable  results. 

When  an  abscess  has  caused  partial  necrosis  of  the  sheath,  it  is 
well  to  pass  a  drain  and  wash  out  the  parts  frequently  with  anti- 
sej)tic  solutions.  For  this  purpose  a  counter-opening  is  made  through 
the  skin  opposite  the  fluctuating  point.  The  mucous  membrane  of 
the  sheath  is  then  cautiously  punctured,  and  a  seton  or  strip  of 
gauze  is  passed  by  means  of  a  seton  needle,  so  as  to  allow  of  con- 
stant drainage. 

PERSISTENCE    OF    THE    URACHUS. 

This  condition  is  an  infirmity  or  congenital  anomaly,  rather  than 
a  morbid  condition.  Persistence  of  the  urachus  after  birth  and  after 
separation  of  the  cord  is  due  to  the  fact  that  the  canal  which  com- 
municates with  the  bladder  fails  to  close  up.  The  urine,  instead 
of  escaping  through  the  urethra,  passes  along  the  urachus,  and  the 
animal  urinates  through  its  umbilicus. 

Causation.  The  causes  are  simple.  Certain  practitioners  have  sug- 
gested that  sex  has  some  influence,  this  being  an  anomaly  occurring 
more  frequently  in  males  than  in  females.  From  investigations  which 
have  been  carried  out,  it  would  appear  that,  in  some  cases,  persistence 
of  the  urachus  is  due  to  an  imperforate  condition  of  the  urethra  ;  in 
other  cases,  to  its  obstruction  by  accumulations  of  mucus  of  a  caseous 
appearance,  which  enter  the  urethra  and  completely  block  the  passage. 


PERSISTENCE   OF   THE   URACHUS.  509 

Finally,  in  other  cases   the    urachus    simply  persists  while  no   lesion 
exists  on  the  side  of  the  urethra. 

Whatever  the  original  cause,  escape  of  urine  by  the  umbilicus  pro- 
duces irritation,  which  may  end  in  complications,  infection  of  the 
unhealed  umbilical  wound,  infection  of  the  canal  of  the  urachus  itself 
and  the  bladder,  or  even  infection  of  the  peritoneum. 

Symptoms.  At  first,  persistence  of  the  urachus  is  shown  by  per- 
manent or  intermittent  discharge  of  urine  through  the  umbilicus. 
Usually  this  discharge  is  only  seen  from  five  to  eight  days  after 
birth,  when  the  necrosed  cord  is  detached ;  in  most  cases  it  is  con- 
tinuous, for  the  opening  is  abnormal  and  has  no  sphincter. 

Contact  with  the  air  and  the  wound  causes  the  urine  to  undergo 
a  kind  of  ammoniacal  fermentation  and  to  irritate  neighbouring  tissues, 
such  as  the  stumps  of  the  umbilical  vessels,  the  interstitial  connective 
tissue,  and  even  the  skin.  The  wound  constitutes  an  excellent  culture 
medium  for  microbes.  The  umbilicus  becomes  swollen  and  cedematous, 
and  soon  exhibits  a  saccular  swelling,  2  to  4  inches  in  diameter,  which, 
on  palpation,  proves  to  be  hot  and  painful ;  its  centre  is  occupied 
by  the  opening  of  the  urinary  fistula.  A  probe  passed  into  this 
fistula  travels  upwards  and  backwards  (see  Fig.  183). 

At  a  later  stage  other  complications,  including  omphalitis  and 
omphalo-phlebitis,  may  set  in.  The  most  frequent  of  the  delayed  com- 
plications is  purulent  cystitis,  with  the  formation  of  purulent  concre- 
tions in  the  bladder,  which  may  occur  even  after  the  fistula  of  the 
urachus  has  healed.  In  other  cases  the  canal  of  the  urachus  con- 
tracts and  becomes  obliterated  towards  the  bladder.  A  blind  fistula 
then  persists,  with  an  opening  at  the  umbilicus,  or,  the  parts  having 
healed  externally,  all  that  remains  is  a  phlegmonous  swelling  with 
the  characteristic  symptoms. 

Diagnosis.  A  thorough  examination  will  invariably  allow  of  urinary 
fistula  being  distinguished  from  other  diseases  of  the  umbilicus,  the 
escape  of  urine  at  this  point  being  so  suggestive. 

Prognosis.  The  prognosis  is  rather  grave,  on  account  of  the  com- 
plications, which  are  possible,  and,  in  fact,  usual,  unless  the  disease 
is  promptly  diagnosed. 

Treatment.  Formerly  as  a  preventive  measure  a  ligature  was  ap- 
plied to  the  whole  mass  of  the  cord  at  birth,  but  this  ligature  in  no 
way  prevents  the  canal  of  the  urachus  persisting  after  the  atrophied 
portion  separates.  Cauterisation  of  the  urinary  fistula  with  Eabel's 
fluid  or  tincture  of  iodine  can  have  no  good  result,  unless  the 
urethra  is  permeable. 

If  the  urethra  is  obstructed  it  is  evidently  from  that  side  that  treat- 
ment should  be  attempted,  either  by  displacing  the  muco-albuminous 


610  URINARY   APPARATUS. 

plugs  with  a  catheter  or  in  some  other  way.  Such  intervention  is 
very  deHcate  and  difficult  in  the  case  of  young  animals.  Sometimes  it 
is  better  to  allow  the  discharge  of  urine  from  the  umbilicus  to  continue, 
and  to  recommend  that  the  animal  should  l)e  rapidly  fattened  for  the 
butcher. 

In  practice,  pervious  urachus  may  be  treated  by  suturing,  by  firing 
across  the  fistula,  and  sometimes  by  blistering.  The  first  step  in  all 
cases  is  to  see  that  the  urethral  passage  is  free.  English  veterinary 
surgeons  claim  to  have  had  a  fair  measure  of  success  from  these 
methods. 

If  a  radical  cure  were  thought  desirable,  the  abdomen  would  have 
to  be  opened,  and  the  operator  would  proceed  to  isolate  the  urachus, 
resect  it,  and  suture  the  base  of  the  bladder  by  bringing  together  its 
external  surfaces.  The  operation,  though  not  perhaps  impossible,  is 
of  no  practical  value. 


CHAPTER    II. 

DISEASES    OF    THE    BLADDER. 

ACUTE     CYSTITIS. 

Cystitis,  or  inflammation  of  the  bladder,  may  be  divided  into  two 
varieties  :  simple  (acute  or  chronic)  cystitis,  and  chronic  cystitis  due  to 
the  presence  of  calculi. 

Simple  acute  cystitis  occurs  most  commonly  in  the  cow,  less  fre- 
quently in  the  ox,  and  rarely  in  the  pig  or  sheep.  Female  animals 
are  more  subject  to  it  than  males. 

It  consists  of  more  or  less  acute  inflammation  of  the  vesical  mucous 
membrane.  The  inflammation  sometimes  extends  to  the  muscular  coat 
and  the  peri-vesical  tissues,  setting  up  local  or  general  peritonitis. 

Causation.  The  internal  causes  to  which  Cruzel  attributes  the 
disease  are  rather  open  to  question.  Eetention  of  urine  in  particular 
is  common  in  working  oxen,  which  only  pass  urine  when  resting,  and 
this  would  be  more  likely  to  produce  distention,  paralysis,  or  rupture 
of  the  bladder  than  true  inflammation  ;  it  is  doubtful  whether  inflam- 
mation would  even  follow  the  chronic  irritation  resulting  from  fre- 
quently repeated  over- distention. 

The  ingestion  of  irritant  plants  certainly  has  a  more  marked  action. 
Irritant  principles  eliminated  by  the  kidneys  might  not  injure  them, 
although  they  would  bring  about  changes  in  the  vesical  mucous  mem- 
brane, with  which  they  would  remain  in  contact  for  some  time. 

More  frequently  cystitis  is  the  result  of  inflammation  due  to  con- 
tinuity of  tissue,  and  forms  a  complication  of  urethritis,  vaginitis, 
and  the  conditions  set  up  by  retention  of  the  after-birth.  It  may 
also  result  from  ascending  infection  causing  pyelo-nephritis,  or  ascend- 
ing infection  of  any  kind  which  eventually  attacks  the  bladder.  It 
is  a  very  common  consequence  of  the  use  of  unclean  catheters,  but 
only  in  equines  and  females,  as  the  catheter  is  not  passed  in  the  ox 
or  bull  until  after  urethrotomy. 

In  by  far  the  majority  of  cases  it  is  of  infectious,  and  not  of  toxic, 
origin. 

Symptoms.  At  first  the  symptoms  are  obscure.  They  commence 
with  slight  colic,  and  are  afterwards  characterised  by  frequent,  difficult 


512  DISEASES   OF   THE   BLADDER, 

and  painful  micturition  and  by  the  small  quantity'  of  urine  passed  on 
each  occasion. 

The  urine,  moreover,  is  modified  in  appearance.  At  first  it  con- 
tains a  small  quantity  of  blood,  and  is  reddish,  or  at  least  of  a  darker 
tint  than  is  usual.  Later  it  becomes  thick  and  whitish,  and  contains 
greyish  films  of  epithelium,  and  the  debris  of  fibrinous  coagula.  The 
microscope  reveals  in  it  the  presence  of  pus  corpuscles,  flat  polygonal 
cells  with  large  nuclei,  and  sometimes  red  blood  corpuscles. 

Locally  almost  all  that  can  be  detected  in  male  animals  is  a  little 
tenderness  of  the  neck  of  the  bladder  on  rectal  examination,  and  in 
females  on  examination  of  the  meatus  urinarius  by  means  of  a 
speculum. 

The  vaginal  mucous  membrane  then  appears  inflamed  around  the 
meatus,  which  itself  is  exceedingly  sensitive. 

In  cases  of  very  marked  inflammation,  accompanied  by  partial 
necrosis  of  the  mucous  membrane  or  the  production  of  false  mem- 
branes, the  temperature  rises  as  high  as  104°  Fahr.  (40°  C),  aj^petite 
disappears,  colic  is  extremely  acute,  and  violent  efforts  to  pass  urine 
are  continually  made  until  the  animal  is  completely  exhausted.  The 
patient  then  refuses  to  walk  about,  but  frequently  lies  down,  arches 
its  back,  and  constantly  makes  efforts  to  urinate,  which  are  abortive 
or  end  only  in  the  passage  of  little  jets  of  fluid. 

The  urine  passed  contains  little  greyish  necrotic  fragments  or  d'ehris 
of  false  membranes,  suggestive  of  diphtheria.  In  female  animals  the 
canal  of  the  urethra  may  also  become  obstructed,  and  rupture  of  the 
bladder,  though  rare,  occasionally  occurs. 

In  the  ordinary  forms  inflammation  persists  for  two  to  three  weeks, 
then  diminishes  in  intensity,  and  either  ends  in  recovery  or  becomes 
chronic. 

In  the  grave  forms,  where  inflammation  and  infection  extend  to  the 
peri-vesical  tissues  and  the  peritoneum,  death  by  peritonitis  is  the  rule. 

On  post-mortem  examination,  the  mucous  membrane  is  seen  to  be 
of  a  greyish  colour,  and  sloughing  or  gangrenous  over  surfaces  of  vary- 
ing size,  whilst  the  surroundings  are  infiltrated,  blackish  and  greatly 
thickened.  The  whole  of  the  connective  tissue  layer  which  supports 
the  peritoneum  near  the  base  of  the  bladder,  and  also  the  adipose 
tissue  around  the  bladder,  are  markedly  inflamed.  At  this  stage  pelvi- 
peritonitis or  generalised  peritonitis  may  occur  as  complications. 

In  the  simple  forms  the  mucous  membrane  is  desquamating,  infil- 
trated, and  covered  with  granulations  of  apparent  healthy  appearance. 

Diagnosis.  The  diagnosis  is  comparatively  easy,  the  external 
symptoms  being  so  clearly  defined.  There  is  a  difficulty,  however, 
in  distinguishing  this  disease  from  cystitis  caused  by  a  calculus.      In 


CHRONIC   CYSTITIS.  513 

male  animals  this  latter  form  of  cystitis  is  characterised  by  freciuent 
spasmodic  contractions  of  the  accelerator  urinne.  In  acute  cystitis,  on 
the  contrary,  the  contractions  are  temporary  only  and  of  no  import- 
ance. Lastly,  in  female  animals  cystitis  due  to  calculus  formation 
is  quite  exceptional,  owing  to  the  large  diameter  and  shortness  of  the 
urethra. 

When  nephritis  and  cystitis  co-exist  certain  signs  indicate  the  fact. 

Prognosis.  The  prognosis  varies,  according  to  the  acuteness  of  the 
disease  and  the  character  of  the  urine  and  epithelial  debris,  which  afford 
valuable  information. 

Treatment.  The  treatment  should  be  directed  towards  relieving  the 
vesical  and  pelvic  pain  and  modifying  the  local  conditions. 

Hot  fomentations  to  the  loins  and  flanks  relieve  pain.  The  adminis- 
tration of  bicarbonate  of  soda  and  of  cold  drinks,  such  as  barley-water, 
decoctions  of  couch-grass  and  pellitory,  mucilage,  etc.,  ai'e  of  service. 
These  materials  are  readily  taken  by  the  patients,  and  have  a  soothing 
effect.  Camphor  also  produces  good  results,  but  benzoate  of  soda  is 
most  useful  on  account  of  the  disinfectant  action  produced  within  the 
bladder,  as  a  consequence  of  the  benzoic  acid  being  separately  eliminated 
by  the  kidney.  Repeated  washing  out  of  the  bladder  with  antiseptic 
solutions  has  been  recommended,  but  is  open  to  criticism.  Such  treat- 
ment is  difficult  in  male  animals,  owing  to  the  special  formation  of 
the  glans  penis  and  urethra,  and  in  female  animals  it  is  by  no  means 
easy.  In  all  cases  of  acute  cystitis,  in  fact,  the  passage  of  the  catheter 
is  painful,  and  as  a  metal,  gutta-percha  or  hard  rubber  sound  is  used, 
the  mere  contact  of  the  tip  of  the  instrument  injures  the  diseased 
mucous  membrane,  makes  it  bleed,  and  gives  rise  to  danger  of  auto- 
inoculation,  with  the  possibility  of  serious  results. 

Those  who  recommend  this  method  of  treatment  can  never  have 
followed  closely  the  development  of  a  grave  case  of  acute  cystitis,  and  if 
the  practice  is  at  all  permissible,  only  a  soft  catheter  should  be  used. 

In  chronic  cystitis,  on  the  other  hand,  washing  out  the  bladder  might 
be  useful. 

CHRONIC    CYSTITIS. 

Chronic  inflammation  of  the  bladder  is  still  rarer  than  acute  cystitis. 
It  usually  attacks  females  as  a  consequence  of  acute  inflammation,  though 
the  condition  may  be  chronic  from  the  first,  in  which  case  the  early 
stages  are  commonly  overlooked. 

Symptoms.  The  chief  functions  of  the  body  do  not  appear  to  be  dis- 
turbed, although  the  urine  §eems  abnormal.  Micturition  is  difficult,  slow, 
and  somewhat  painful,  and  is  followed  l)y  long-continued  tenesmus. 

The  urine   appears  whitish,  purulent,   slimy,  or  of  a   deeper   tint, 

D.C.  L  L 


514  DISEASES   OF   THE    BLADDER. 

rapidly  becoming  blackish.  It  is  of  ammoniacal  or  iwtid  odour,  and 
decomposes  quickly. 

The  period  of  development  may  be  prolonged,  and  recovery  rarely 
occurs  spontaneously.  The  condition  often  leads  to  ascending  infection, 
inflammation  of  the  ureters,  pyelitis,  and  nephritis. 

On  post-mortem  examination  of  animals  slaughtered  before  com- 
plete wasting  has  occurred  the  vesical  mucous  membrane  is  found  to 
be  thickened,  granulating,  or  suppurating.  The  muscular  tissue  shows 
infiltration  and  localised  sclerosis,  and  is  very  irregularly  thickened, 
inelastic,  and  wanting  in  contractile  power.  The  peri-vesical  tissues 
may  be  chronically  inflamed. 

Diagnosis.  The  diagnosis  is  easy,  provided  the  peculiar  charac- 
teristics of  the  urine  are  noted,  and  an  examination  is  made  through 
the  vagina  of  the  condition  of  the  walls  of  the  bladder,  of  the  ureters 
and  of  the  kidneys. 

Prognosis.  The  prognosis  is  grave,  because  treatment  would  occupy 
too  much  of  the  practitioner's  time  to  allow  it  to  be  rigorously  carried 
out,  and  therefore  animals  are  'usually  slaughtered. 

Treatment.  Treatment  comprises  the  use  of  many  of  the  drugs 
used  in  acute  cystitis,  particularly  benzoate  of  soda,  benzoic  acid,  and 
bicarbonate  of  soda.  The  medicines  comprised  in  the  balsamic  group 
are  also  valuable,  viz.,  turpentine,  tar,  and  terpin. 

In  this  chronic  form  the  bladder  should  be  irrigated,  but  this  must 
be  done  with  strict  aseptic  precautions,  the  fluids  used  being  cooled 
boiled  water,  boric  acid  or  borax  solution  of  3  per  cent,  strength,  or 
solution  of  fluoride  of  soda  of  a  strength  of  15  grains  to  the  quart. 

We  need  not  point  out  the  difficulties  of  pursuing  this  treatment  in 
ordinary  practice.  As  a  rule,  treatment  is  confined  to  internal  medi- 
cation whilst  the  animals  are  fattened. 


URINARY    LITHIASIS.      CALCULUS    FORMATION. 

Normally  the  urine  contains  in  solution  certain  salts,  such  as  urates, 
hippurates  and  phosphates  of  lime,  magnesia  or  ammonia.  Under  cer- 
tain circumstances,  in  animals  predisposed  to  the  condition,  these  salts 
are  precipitated  in  the  kidneys,  ureters  or  bladder,  and  form  powdery 
or  sandy  deposits  known  as  sediments  ;  or,  on  the  other  hand,  calculi, 
produced  by  the  adhesion  of  the  powdery  masses.  This  constitutes 
urinary  lithiasis. 

The  sediments  are  of  a  greyish-yellow  colour. 

The  calculi  are  generally  rose-coloured,  white  or  somewhat  gre3^ 
They  contain  oxalates  and  carbonates  of  lime  and  magnesia,  earthy 
phosphates,  etc.     In  appearance  and  shape  they  vary  greatly.      They 


URINARY    LITHIASIS.  515 

may  resemble  coral  or  may  form  growths  of  a  rounded,  polyhedric  or 
raspberry  appearance.  Some  are  hard  and  resistant ;  others  friable. 
They  vary  in  size  between  that  of  a  grain  of  sand  and  a  hen's  egg  or 
more.  A  large  calculus  is  usually  solitary ;  the  smaller  sizes  are  often 
multiple. 

Calculi  occur  in  oxen  and  sheep,  but  more  particularly  in  the  latter 
species.  They  develop  slowly  without  producing  any  marked  external 
signs,  and  often  it  is  only  when  the  urethra  becomes  obstructed  and 
urine  is  retained  that  the  diagnosis  is  established.  Calcuh  are  rare 
in  females  in  consequence  of  the  dilatability  of  the  urethra. 

CALCULI  IN  BOVINE  ANIMALS. 

Causation.  The  older  writers  believed  that  calculi  developed  through 
winter  feeding  and  a  stinted  supply  of  water.  Nowadays  this  would  not 
apply  to  well-managed  establishments,  water  being  provided  regularly, 
and  winter  feeding  comprising  roots,  etc.,  rich  in  water.  Experience 
and  observation  have  shown  that  the  chief  cause  is  excessive  feeding, 
calculus  formation  occurring  most  frequently  in  animals  which  are 
most  richly  fed. 

Nevertheless,  it  would  be  a  mistake  to  overlook  the  effects  of 
temperament  and  constitution.  In  human  medicine  the  importance 
of  hereditary  predisposition  and  of  the  special  diathesis  is  undeniable 
(uric  or  gouty  diathesis).  In  veterinary  medicine  the  same  thing 
applies,  for,  apart  from  rich  feeding,  it  is  not  uncommon  to  meet  with 
cases  of  gravel  in  animals  living  under  the  most  diverse  conditions, 
although  the  issue  of  the  same  parents. 

Certain  infections  of  the  urinary  passages,  though  trifling  at  first, 
or  at  least  of  slow  development,  are  also  capable  of  causing  mineral 
deposits  in  the  urinary  passages,  a  fact  which  Moussu  considers  to  be 
proved  by  his  success  in  experimentally  reproducing  given  forms  of 
pyelo-nephritis. 

Symptoms.  The  symptoms  are  often  overlooked,  as  long  as  the 
calculus  deposits  affect  only  the  kidneys,  their  increase  in  that  part 
not  giving  rise  to  alarming  symptoms.  It  is  certain  that  the  eventual 
passage  of  the  calculus  through  the  ureter  towards  the  bladder  causes 
nephritic  colic,  but  this  form  of  colic  is  little  understood,  and  has 
never  been  well  described.  Writers  have  simply  mentioned  cases  of 
colic  accompanied  by  great  tenderness  in  the  lumbar  region,  temporary 
suspension  of  the  secretion  of  urine,  and  more  or  less  marked  dysuria. 

Nothing  resembling  the  extremely  grave  symptoms  of  nephritic  colic 
in  mankind  has  been  described,  though  probably  there  is  little  differ- 
ence in  the  complaint  as  it  affects  the  bovine  species. 

L  L  2 


516  DISEASES   OF   THE   BLADDER. 

When  the  sediment  or  the  calculus  reaches  the  hladder  there  is  a 
tendency  for  it  to  be  i^assed  during  micturition.  The  signs  then  become 
more  strongly  marked,  because  they  point  to  obstruction  of  the  urethra. 
If  the  deposit  is  simply  of  the  nature  of  sediment,  there  is  merel}^  a 
little  difficulty  in  urination,  accompanied  by  some  moderate  amount  of 
pain,  and  sediment  is  afterwards  found  within  the  sheath  or  adhering 
to  the  groups  of  hair  at  its  extremity'. 

If,  however,  the  deposit  is  in  the  form  of  small  calculi,  these  are 
pushed  towards  the  neck  of  the  bladder  and  the  urethra,  which  then 
appears  to  be  obstructed. 

The  obstruction  may  occur  at  the  origin,  at  the  ischial  curve,  or 
at  the  S-shaped  curve  of  the  penis  (Fig.  226).  Henceforth  strongly 
marked  and  unmistakable  symptoms  rapidly  develop.  Vesical  colic 
appears,  owing  to  retention  of  urine,  and  rapidly  acquires  extreme 
intensity,  though  it  instantly  ceases  with  rupture  of  the  bladder  in 
cases  where  no  treatment  is  attempted.  This  form  of  vesical  colic  is 
accompanied  by  continual  but  unsuccessful  efforts  to  urinate  and  by 
spasmodic  contractions  of  the  accelerator  urinae. 

Appetite  and  rumination  cease,  and  the  animal  shows  extreme  anxiety. 
Palpation  along  the  course  of  the  penis  reveals  unusual  tenderness,  and 
the  calculus  can  sometimes  be  felt  near  the  S  curve,  though  more  fre- 
quently in  the  ischial  arch.      The  litter  is  not  soiled  with  urine. 

Cautious  rectal  examination  proves  the  bladder  to  be  extremely 
distended,  or,  in  the  case  of  rupture  having  occurred,  entirely  col- 
lapsed. In  the  latter  case  the  spasmodic  contraction  of  the  accelerator 
urinae  completely  ceases  soon  after  rupture,  and  the  animal  appears  to 
be  recovering.  This  deceptive  calm  is  due  to  the  disajDpearance  of  the 
vesical  colic,  but  the  animal's  condition  is  still  graver  in  consequence, 
and  it  must  of  necessity  die.  Rupture  of  the  bladder  is  followed  by 
inundation  of  the  peritoneal  cavity  with  urine,  which  is  partly  re- 
absorbed by  the  peritoneum,  producing  a  kind  of  urinary  intoxication, 
so  that  despite  the  elimination  of  cel'tain  volatile  principles  through 
the  lungs  (the  breath  has  an  odour  suggestive  of  urine),  the  animal 
very  soon  dies. 

In  many  cases,  also,  the  urine  is  not  aseptic,  and  after  rupture  of 
the  bladder  acute  peritonitis  supervenes  and  carries  off  the  patient  in 
from  six  to  ten  days. 

Even  when  the  urine  appears  to  be  aseptic,  chronic  exudative  peri- 
tonitis is  produced  by  the  irritant  action  of  the  urine  on  the  peritoneal 
endothelium.  The  exuded  liquid  mixes  with  the  urine,  and  the  animal 
soon  shows  marked  ascites.  Despite  this  condition,  some  animals  have 
been  known  to  survive  as  long  as  from  three  to  six  weeks  without 
showing  very  marked  disturbance. 


URINARY   LITHIASIS.  517 

Death  is  the  mevitable  sequel  after  a  longer  or  shorter  Ihne.  When 
large  calculi  have  been  arrested,  or  rather  developed,  in  the  bladder 
the  same  symptoms  occur  should  the  calculus  be  thrust  towards  the 
neck  of  the  bladder  so  as  completely  to  obliterate  the  passage.  This, 
however,  is  a  very  rare  accident.  As  a  rule  the  obstruction  is  merely 
temporary,  and  the  resulting  vesical  colic  and  retention  last  but  a 
short  tiine.  The  displaced  calculus  falls  back  again  into  the  lower 
part  of  the  bladder,  where  it  is  retained,  and  the  urinary  passages 
again  become  free. 

Diagnosis.  The  diagnosis  is  sometimes  extremely  easy,  but  it  may 
present  serious  difficulty. 

When  the  urethra  is  obstructed,  the  symptoms  are  so  striking  that 
there  can  scarcely  be  any  doubt ;  but  the  diagnosis  of  renal  calculus, 
nephritic  colic,  calculus  in  the  bladder,  and  rupture  of  the  bladder 
demands  more  attention.  Examination  of  the  urinary  organs  through 
the  rectum  then  proves  of  great  service. 

Prognosis.  The  prognosis  is  grave  in  all  cases,  because  of  the  pos- 
sibility of  the  urinary  passages  being  obstructed,  so  that  surgical  inter- 
ference is  necessary. 

Lesions.  The  lesions  caused  by  urinary  calculi  may  vary  greatly. 
Though  insignificant  and  scarcely  apparent  in  certain  cases,  they  are 
often  very  marked,  and  comprise  simple  or  suppurative  pyelitis,  in- 
flammation of  the  ureters,  hydro-nephrosis,  cystitis  of  varying  intensity, 
urethritis,  and  inflammation  of  the  sheath. 

Treatment.  All  farmers  who  fatten  their  animals  know  that  the 
use  of  alkaline  drugs,  such  as  bicarbonate  of  soda,  together  with 
diuretics,  linseed,  barley  and  pelUtory  diminish  the  danger  of  urinary 
calculus  formation.  Bicarbonate  of  soda  is  often  given  with  this  object, 
and  is  excellent  in  cases  where  lithiasis  does  not  extend  beyond  the 
production  of  sandy  or  muddy  deposits.  By  rendering  the  urine  more 
alkaline  it  prevents  the  growth  of  sabulous  deposits,  and  may  even 
cause  slow  but  progressive  solution  of  concretions  already  formed. 
When,  on  the  other  hand,  the  urethra  is  obstructed,  and  urine  is 
retained,  early  surgical  treatment  (urethrotomy)  alone  offers  any  chance 
of  preventing  rupture  of  the  bladder. 

Certainly  it  is  possible,  as  recommended  by  the  older  practitioners, 
to  try  massage  of  the  glans  penis  and  urethra  opposite  the  obstruction, 
and,  after  withdrawing  the  penis,  to  attempt  to  loosen  and  eject  the 
obstructing  matter.  But  such  attempts  very  frequently  fail,  because 
the  material  is  too  firmly  fixed,  and  no  time  must  be  lost. 

Urethrotomy  is  usually  practised  at  one  of  two  points,  according  to 
circumstances — firstly,  opposite  the  ischial  arch;  and,  secondly,  opposite 
the  S- shaped  curve. 


518  DISEASES    OF   THE    BLADDER. 

Ischial  urethrotomy  is  the  promptest  method  of  affordmg  rehef, 
and  should  always  be  preferred  whenever  there  is  danger  of  rupture 
of  the  bladder. 

It  is  performed  in  the  standing  position,  but  is  only  possible  when 
the  animal  is  not  too  fat. 

In  other  cases  urethrotomy  is  performed  opposite  the  point  where 
the  calculus  is  fixed,  and  aims  at  removing  the  obstruction.  It  can 
only  be  practised  after  casting  the  animal ;  but,  in  this  case  also,  it  is 
indispensable  that  the  animal  should  not  be  excessively  fat,  as  in  such 
cases  a  secondary  urinary  abscess  is  almost  certain  to  form. 

Should  the  animal  be  so  fat  as  to  render  treatment  difficult,  it  is 
best  to  slaughter  it  at  once. 


URINARY  CALCULI  IN  SHEEP. 

Urinary  calculi  are  commoner  in  sheep  than  in  oxen,  and  seem  to 
depend  more  on  the  breed  and  on  conditions  of  feeding.  They  are 
almost  exclusively  confined  to  animals  which  are  richly  fed,  to  show 
animals,  and  to  males.  In  exceptional  cases  they  are  seen,  under 
ordinary  conditions  of  feeding,  in  aged  subjects. 

Calculus  formation  can  moreover  be  induced  experimentally,  and  in 
a  relatively  short  time,  by  giving  certain  rations — e.g.,  7  lbs.  per  day 
of  maize,  lentils  and  beans  for  adults,  and  3  lbs.  for  lambs.  The  other 
favouring  circumstances,  viz.,  hereditary  gouty  diathesis  and  infection, 
are  less  well  established  than  they  are  in  the  case  of  the  ox. 

In  sheep  the  symptoms  are  still  less  characteristic  than  in  oxen, 
for  which  reason  gravel  in  sheep  merits  special  description. 

It  shows  itself  in  the  passage  of  turbid  urine,  forming  a  deposit  at 
the  extremity  of  the  sheath,  which  becomes  somewhat  inflamed.  The 
colic  resulting  from  retention  of  urine  is  shown  by  depression,  want 
of  appetite,  dysuria,  and  generalised  convulsive  shivering  fits. 

The  patients  lie  down  in  the  sterno-abdominal  or  sterno-lateral  posi- 
tion. They  constantly  suffer  from  attacks  of  general  violent  shivering, 
and  die  after  twelve,  twenty-four,  or  forty-eight  liours. 

On  post-mortem  examination  the  bladder  is  found  to  be  ruptured, 
or  the  urethra  obstructed. 

Diagnosis.  The  diagnosis  involves  no  difficulty,  provided  the  method 
of  feeding  is  understood.  In  many  cases  the  shepherds  themselves  per- 
fectly recognise  the  cause  of  the  symptoms. 

Prognosis.  The  prognosis  is  very  grave,  it  being  impossible  to  pass 
the  catheter  on  account  of  the  perineal  valve  in  the  urethra,  while  it  is 
difficult  to  operate,  the  urethra  being  very  small  and  deeply  embedded 
in  a  thick  layer  of  fat. 


EVERSION    OF    THE    BLADDER.  519 

Treatment.  The  only  resource  is  massage  along  the  urethra,  which 
may  sometimes  break  up  the  mass  of  sediment  or  move  the  obstruct- 
ing calcuhis.  One  remark  may,  however,  be  made,  viz.,  that  in  the 
majority  of  cases  the  urethra  is  obstructed  at  its  extremity  by  local 
accumulations  of  sediment  behind  the  spiral  filiform  prolongation  of 
the  penis. 

It  is  then  sufficient,  and  experienced  shepherds  have  no  hesitation 
in  performing  the  operation,  to  remove  the  spiral  filament,  thus  facili- 
tating the  expulsion  of  the  sediment  and  aftbrding  relief.  If  both 
methods,  viz.,  massage  and  section  of  the  filament,  fail,  the  animal 
should  be  slaughtered,  so  as  to  avoid  rapture  of  the  bladder,  which 
would  render  the  flesh  useless  as  food. 

From  a  preventive  standpoint,  all  sheep  which  are  richly  fed  should 
receive  an  allowance  of  some  slightly  alkaline  drink. 

PARALYSIS  OF  THE  BLADDER. 

Paralysis  of  the  l)ladder  is  somewhat  frequent  in  female,  but  very 
rare  in  male,  animals.  In  the  majority  of  cases  it  is  the  consequence 
of  difficult  parturition,  or  is  a  post-partum  complication. 

It  is  characterised  by  incontinence  of  urine  or  retention  with  over- 
flow. The  continuous  discharge  soils  the  hind  quarters,  hocks,  shanks, 
pasterns,  etc.,  and  the  urine  decomposes  and  causes  irritation;  it  soon 
sets  up  urinary  eczema  in  all  the  parts  with  which  it  comes  in  contact, 
a  condition  which  can  only  be  successfully  treated  by  removing  the 
cause. 

The  prognosis  is  grave,  for  methods  of  treatment  are  few,  and  of 
doubtful  efficac}'. 

Treatment.  If  the  condition  results  from  post-j)artum  infection, 
this  must  naturally  first  receive  attention.  Should  the  infection  have 
disappeared  whilst  incontinence  of  urine  still  continues,  the  adminis- 
tration of  tonics,  e.r/.,  tincture  of  nux  vomica  in  daily  doses  of  f  to 
1  drachm  for  ten  days  or  so  in  the  case  of  a  bovine  animal,  and  a 
stimulating  application  to  the  lumbo-sacral  region,  may  bring  about 
recovery. 

But  if,  in  spite  of  such  treatment,  the  incontinence  persists,  it  is 
better,  fi'om  an  economic  standpoint,  to  treat  the  urinary  eczema  with 
astringents,  etc.,  and  quickly  to  fatten  the  animal. 

EVERSION    OF    THE    BLADDER. 

Eversion  of  the  bladder  only  occurs  in  female  animals  after  difficult 
parturition.  The  viscus  is  turned  completely  inside  out,  as  occurs  in 
^version  of  .the  uterus,  the  base  of  the  bladder  becoming  invaginatecl  iii 


520  DISEASES    OF    THE   BLADDER. 

the  cavitj^  of  the  bhidder  itself,  and  afterwards  passmg  into  the  urethra 
and  vagina.  The  bladder  thus  becomes  totally  displaced,  and  appears 
between  the  lips  of  the  vulva,  resting  on  the  inferior  commissure,  and 
forming  a  mass  the  size  of  an  orange. 

Eversion  cannot  occur  unless  the  ligaments  of  the  bladder  have 
become  relaxed,  stretched  or  ruptured.  Expulsive  efforts  and  the 
pressure  of  the  intestinal  mass  complete  the  process,  the  peritoneum 
and  peri-vasicular  la^^ers  of  connective  tissue  being  torn. 

Diagnosis.  The  diagnosis  of  eversion  of  the  bladder  presents  no 
difficulty.  The  everted  mass  appears  to  have  a  narrow  neck  opposite 
the  meatus,  and  is  seen  to  form  a  reddish,  unctuous  mass.  The  mucous 
membrane  now  forms  the  external  coat  and  appears  covered  with  mucus 
BO  long  as  inflammation  does  not  occur. 

The  urine  continually  escapes  from  the  ureters  (which  open  on  the 
surface  of  the  mucous  membrane)  as  it  is  formed,  and  flows  away  by 
the  lower  commissure  of  the  vulva.  The  vulva  is  half  open,  and  the 
prominence  formed  by  the  bladder  projects  beyond  it. 

Prognosis.  The  prognosis  is  grave,  because  reduction  is  difficult, 
and  may  be  accompanied  by  rupture  of  the  organ;  also  because  even 
in  favourable  cases  it  is  invariably  followed  by  acute  cystitis. 

Treatment.  Treatment  is  confined  to  reduction.  Before  attempting 
this,  measures  must  be  adopted  to  prevent  straining,  either  by  passing 
a  rope  round  the  animal's  body,  thus  causing  it  to  flex  the  vertebral 
column,  or  by  puncturing  the  rumen  or  performing  tracheotomy.  The 
open  hand  is  then  applied  to  the  surface  of  the  swelling,  which  is  gently 
compressed  and  thrust  in  turn  through  the  meatus  and  urethra.  The 
portions  nearest  to  the  urethra  should  first  be  returned.  It  is  some- 
times necessary  to  use  both  hands,  and  even  to  employ  a  catheter  with  a 
large  round  head,  to  reduce  the  eversion  effectually.  After  reduction  a 
truss  or  vulval  clamp  should  be  applied.  Subsequent  treatment  con- 
sists in  the  administration  of  sedatives — e.g.,  laudanum,  mucilaginous 
drinks,  barley-water,  pellitory,  etc. 

HEMATURIA. 

Hfematuria,  i.e.,  the  passage  of  blood-stained  urine,  is  in  itself  only 
a  symptom,  which  may  accompany  very  varying  conditions,  such  as 
the  congestion  peculiar  to  the  early  stages  of  nephritis,  traumatic 
lesions  of  the  kidneys,  ulceration  of  the  uriniferous  tul)ules,  or  of  the 
pelvis  of  the  kidney,  lesions  of  the  ureters,  bladder,  etc.,  etc.  The  term, 
therefore,  does  not  indicate  a  disease,  but  nevertheless  in  l)ovine  practice 
the  term  hsematuria  has  acquired  a  special  significance. 

This  hsematuria  of  bovine  animals  is  clinically  indicated  by  the 
presence  of  blood  in  the  urine :  anatomically  by  lesions  of  the  bladder, 


BMMATVIUA.  521 

sometimes  also  of  the  ureters.  It  is  probable  that  some  forms  at  least 
of  the  condition  will  ultimately  be  proved  to  be  due  to  the  piroplasmata, 
but  in  the  present  state  of  our  knowledge  the  disease  can  only  be 
described  from  the  clinical  standpoint.  The  reader  is  recommended  to 
refer  to  the  article  on  "  Bovine  Piroplasmosis,"  ante. 

Pichon  in  1863  and  Sinoir  in  1864  introduced  the  name  "hfPnia- 
turia"  in  the  course  of  their  remarkable  investigations  concerning  tlie 
disease.  Yigney  in  1845  and  Gillet  in  1862  had  previously  described 
it,  and  it  has  since  formed  the  subject  -of  constant  researches. 

Detroye  in  1891  termed  it  "essential  hematuria,"  and  Galtier  in 
1892  gave  it  the  name  of  "  haemorrhagic  cystitis."  Boudeaud  in  1894 
also  used  the  term  "  hematuria  of  bovine  animals."  In  Germany 
the  disease  is  known  as  "  stallroth  "  (stable-red). 

Geographical  distribution.  Hsematuria  is  a  perfect  scourge  in  cer- 
tain countries.  It  seems  to  have  made  its  appearance  in  the  depart- 
ments of  the  West  of  France,  the  Mayenne  and  the  Sarthe,  afterwards 
spreading  into  the  Maine-et-Loire  and  the  Indre.  At  the  present  day, 
it  inflicts  great  ravages  in  the  Creuze,  the  Correze,  Haut-Vienne, 
Cantal  and  Haute-Loire  districts.  It  has  been  described  in  Germany, 
Belgium,  and  Italy.  These  forms  are  probably  due  to  I'irojdasma 
bif/cminiDii. 

Causation.  The  most  varying  opinions  have  been  advanced  regard- 
ing its  cause.  Pichon  believed  its  appearance  was  due  to  changes  in 
cultivation,  which  between  1830  and  1860  completely  altered  the  general 
appearance  of  the  country  and  the  conditions  of  breeding  in  the  old 
province  of  Maine.  Land  reclamations  and  the  use  of  lime  dressings 
have  been  mentioned,  as  well  as  the  introduction  of  the  Durham  breed 
of  cattle.  Sinoir  practically  adopts  the  latter  view,  for  he  considers  that 
the  crossing  with  the  Durham  breed,  while  increasing  the  precocity,  has 
diminished  the  powers  of  resistance  of  the  indigenous  cattle. 

But  in  course  of  time  these  ideas  have  become  modified,  and  in- 
vestigation has  taken  a  new  direction.  Detroye  regarded  the  disease  as 
a  microbic  and  easily  transmissible  disorder,  while  Galtier  in  the  follow- 
ing year  described  it  as  merely  a  chronic  hemorrhagic  cystitis,  j^roduced 
l)y  the  consumption  of  irritant  plants  in  animals  previously  suffering 
from  distomatosis.  In  Germany,  Arnold  attributed  "'  stallroth "  to 
coccidia  developing  in  the  epithelium  of  the  vesical  mucous  membrane. 

Cruzel  considered  the  disease  to  be  due  entirely  to  poor  feeding. 
Boudeaud  thought  the  same.  He  says  that  hematuria  affected  one- 
tenth  of  the  whole  of  the  oxen  in  the  south  of  the  Indre  and  the  north 
of  the  Creuze,  in  parts  where  the  arable  soil  is  thin  and  poor  in  phos- 
phoric acid.  Furthermore,  he  suggests  that  dressings  with  lime  and 
phosphates  would  result  in  the  disappearance  of  hematuria. 


522  DISEASES    OF   THE    BLADDER. 

We  cannot  adniit  that  poor  forage  and  feeding  alone  are  sufficient 
to  produce  ha^maturia,  for  one  frequently  sees  poorly  nourished  animals 
pass  through  all  the  stages  of  wasting  and  most  profound  cachexia  with- 
out ever  showing  signs  of  this  particular  ailment.  Besides,  luematuria 
nmy  attack  animals  in  good  condition, 

Detroye's  early  opinion  as  to  the  infectious  or  microhic  nature  of 
the  disease  seems  scarcely  more  acceptable,  for  it  now  appears  certain 
that  the  organism  originally  described  is  incapable  of  producing  the 
disease. 

Galtier's  theory  is  still  less  admissible.  According  to  the  Lyons 
professor,  hnematuria  occurs  only  in  animals  suffering  from  distomatosis. 
The  liver,  he  says,  being  affected  by  the  growth  of  liver  flukes,  no  longer 
performs  its  proper  work  of  destroying  toxins,  and  if  under  these  con- 
ditions the  animals  eat  improper  food  containing  ranunculaceae,  sedges, 
rushes,  etc.,  the  toxic  principles  of  these  plants  are  absorbed.  Then, 
he  adds,  these  principles  being  no  longer  destroyed,  are  eliminated  by 
the  kidneys,  their  stay  in  the  bladder  causes  irritation,  and  hiemorrhagic 
cystitis  is  set  up,  this  being  afterwards  maintained  by  microbic  agents 
in  the  bladder. 

This  very  specious  theory,  all  the  points  in  which  may  readily  be 
refuted,  in  our  opinion  falls  to  the  ground  before  the  simple  fact  that 
haematuria  occurs  in  animals  which  present  no  trace  of  distomatosis 
on  post-mortem  examination,  and  that,  furthermore,  it  is  not  seen  in 
the  lower  regions  of  the  departments  of  the  Nord,  the  Pas-de-Calais 
and  the  Somme,  where  ranunculacete  and  other  irritant  plants  are 
common  and  distomatosis  rages. 

Moussu  states  that  he  has  proved  that  hematuria  is  very  rare  in 
young  animals  and  is  exceptional  befoi'e  the  age  of  two  and  a  half 
years  or  three  years  ;  that  it  attacks  oxen  as  often  as  cows  ;  that  it 
is  particularly  common  in  low  regions ;  and  that  it  is  scarcely  ever 
seen  above  a  height  of  800  yards.  Careful  investigation,  moreover, 
shows  that  the  passage  of  blood  occurs  just  as  frequently  in  winter, 
when  the  animals  are  housed,  as  in  spring,  when  at  pasture. 

Lesions.  The  lesions  of  hsematuria  are  to  be  found  in  the  bladder, 
though  in  exceptional  cases  they  may  also  affect  the  ureters  and  kid- 
neys. They  have  l)een  described  by  Pichon  and  Sinoir,  but  as  these 
observers  regarded  the  condition  as  a  disease  of  the  blood  due  to  poor 
feeding,  etc.,  they  did  not  attach  much  importance  to  them.  Detroye 
has  described  the  different  appearances  very  well,  though  Moussu 
states  that  he  has  never  met  with  the  "  blisters  "  which  he  mentions. 

The  fi[rst  period  is  accompanied  simply  by  abnormal  vascularity  of 
the  bladder,  which  appears  in  the  form  of  true  varicosities  of  the 
sub-mucous  vessels  and  intra-mucous  capillaries.      But  if  tbis  lesioii 


HEMATURIA.  523 

is  primary,  it  does  not  correspond  to  the  period  during  which  blood- 
stained urine  is  passed,  and  is  not  sufficient  to  explain  it.  It  always 
appears  in  the  form  of  a  more  or  less  abundant  hasmorrhagic  intra- 
mucous,  sub-ej)ithelial  spotting. 

Over  the  hsemorrhagic  area,  which  may  be  of  very  varied  dimensions, 
ranging  from  those  of  a  small  pin's  head  to  those  of  a  lentil,  the  epithe- 
lium is  swollen  and  loosened,  and  so  separated  from  the  surrounding 
parts  as  to  have  lost  its  vitality.  This  patch  of  separated  epithelium 
soon  falls  away,  leaving  an  epithelial  ulceration  of  the  mucous  mem- 
brane. The  subjacent  clot  rapidly  breaks  up  in  contact  with  the 
liquid  in  the  bladder,  and  is  replaced  by  a  small  ulceration  which 
becomes  the  seat  of  continual  capillary  haemorrhage.  Nevertheless,  the 
neighbouring  tissues  react,  and  the  process  of  repair  may  end  either 
in  true  cicatrisation,  which  appears  to  be  rare,  or  more  frequently  in 
the  formation  of  exuberant  granulations,  which  are  also  of  the  nature 
of  a  soft,  bleeding  vegetation.  This  vegetation  is  either  sessile  or 
pedunculated,   and  is  of  very  varying  size. 

The  wall  of  the  bladder  also  reacts,  becoming  sclerosed  and  thickened 
beneath  the  granulations,  so  that,  in  animals  which  have  long  suffered 
from  haematuria,  it  may  entirely  have  lost  its  dilatability. 

When  the  disease  has  existed  for  a  certain  time,  sub-epithelial 
haemorrhages,  ulcerations,  vegetations  and  points  of  sclerosis  may  all 
co-exist,  a  fact  which  shows  that  the  disease  does  not  develop  all 
at  once,  but  that,  on  the  contrarj^  every  little  lesion  develops  sepa- 
rately and  continuously.  This  fact  also  explains  the  length  of  time 
for  which  blood  may  be  passed,  despite  the  presence  of  old  or  healed 
lesions. 

Finally,  in  very  old  standing  cases  dating,  from  several  years  back 
(Moussu  saw^  an  animal  aged  twenty-eight  years  which  had  suffered 
from  this  disease  for  more  than  twenty  years,  but  in  a  very  inter- 
mittent fashion),  it  is  not  exceptional  to  find  numerous  papilliform 
vegetations  1  or  2  inches  in  length,  either  wdth  a  fine  pedicle  or 
largely  sessile,  invading  one-half  or  two-thirds  of  the  internal  surface 
of  the  bladder. 

These  vegetations  sometimes,  though  rarely,  invade  the  ureters. 
When  they  occur  towards  the  point  where  these  conduits  enter  the 
bladder,  they  obstruct  the  passage  of  urine,  and  lead  to  the  develop- 
ment of  hj^dro-nephrosis  or  pyelo-nephritis. 

Symptoms.  The  early  symptoms  often  escape  notice,  because 
general  disturbance  is  rare.  The  first  appreciable  signs  are  cystitis 
and  frequent  urination. 

The  urine  passed  is  turbid,  particularly  towards  the  end  of  the  act 
of  urination  ;   then  it  is  of  a  pink  or  red  colour,  and  all  intermediate 


524  DISEASES    OF    THE    HLADDER. 

shades  between  a  pale  pink  and  a  bright  arterial  red  colour  may  be 
observed. 

The  patients  sometimes  seem  to  pass  unaltered  blood  in  the 
urine,  but  on  microscopic  examination  this  blood  is  found  to  be 
extremely  diluted.  Provided  the  bladder  is  not  gravely  infected  by 
the  (secondary)  penetration  of  germs  into  its  cavity  the  blood  cor- 
puscles remain  normal,  or  are  scarcely  changed.  As  soon  as  the 
bladder,  however,  becomes  secondarily  infected  an  almost  immediate 
change  takes  place  ;  the  red  blood  corpuscles  become  crenated, 
broken  up.  and  dissociated  ;  the  haemoglobin  is  also  partly  dissolved 
and  modified,  and  at  this  stage  the  urine  is  red-brown  or  coffee- 
coloured,  according  to  the  length  of  time  it  has  been  retained  in  the 
bladder. 

In  other  cases,  chiefly  when  hsematuria  has  existed  for  some  time, 
the  extravasated  blood  coagulates  in  the  bladder,  and  the  urine  passed 
contains  filamentous  clots  the  size  of  a  man's  thumb,  a  pigeon's  egg, 
or  more.  If  the  clots  formed  are  too  large  to  be  passed,  which  is 
often  the  case  in  the  ox,  they  may  obstruct  the  urethra,  causing 
retention  of  urine  and  all  the  accidents  which  accompany  this  con- 
dition, even  including  rupture  of  the  bladder.  This,  in  the  ox,  is  a 
frequent  termination.  In  the  cow  the  dilatability  and  shortness  of 
the  urethra  render  retention  of  urine  much  rarer.  It  is  certainly 
possible,  however,  and  it  is  not  exceptional,  to  find  from  4  to  6  lbs. 
of  clotted  matter  in  the  distended  bladder.  All  these  conditions  can 
be  detected  by  rectal  exploration,  and  by  attention  to  the  symptoms 
of  obstruction  of  the  urethra. 

Whenever  there  is  retention  of  clots  dysuria  is  extremely  marked 
and,  so  to  speak,  permanent,  the  animals  having  continual  tenesmus. 

Hsematuria  observes  a  slow,  progressive  course,  which,  in  time,  ends 
in  death  by  exhaustion,  though  this  is  not  invariably  the  case.  Hfema- 
turia  is  frequently  intermittent,  and,  after  having  been  very  marked  for 
weeks  or  months,  may  suddenly  or  gradually  cease,  and  only  reappear 
a  long  time  afterwards.  This  fact  is  explained  by  a  study  of  the  de- 
velopment of  the  lesions.  When  ulceration  occurs  the  sub-epithelial 
vessels  of  the  mucous  membrane,  which  have  contributed  to  the  forma- 
tion of  the  hpemorrhagic  spot,  are  widely  open,  and  a  capillary  haemor- 
rhage results  ;  but  as  soon  as  a  small  clot  forms  in  this  position,  or  local 
capillary  thrombosis  occurs,  the  haemorrhage  ceases,  with  the  result  that 
the  hfematuria  disappears.  Unfortunately,  however,  the  obliterating 
clots  are  not  permanent,  any  more  than  the  local  thrombosis — or,  in 
the  event  of  their  proving  permanent,  another  small  lesion  develops  at  a 
different  point,'  and  this  lesion  may  at  any  time  cause  the  reapi)ear- 
ance  of  the  hsematuria ;  the  process  goes  on  until  the  animal  succumbs. 


HEMATURIA.  525 

Should  the  lesions  heal  successively,  spontaneous  recovery  may  take 
place,  but  such  recovery  is  exceptional. 

The  animals  may  not  appear  to  suffer  from  the  passage  of  blood  for 
weeks  or  even  months,  but  after  a  time  they  become  less  capable  of 
replacing  the  loss.  They  become  anaemic,  the  number  of  corpuscles 
falls  from  the  normal  figure'  of  from  six  to  seven  millions  of  red  cor- 
puscles per  cubic  millimetre  to  three  millions,  two  millions,  one 
million,  and  even  to  five  hundred  or  eight  hundred  thousand. 

The  richness  in  hapmoglobin  simultaneously  diminishes  ;  wasting 
progresses  to  the  point  of  cachexia,  and  the  appetite  diminishes  while 
diarrhcea  appears  ;  swellings  are  noticeable  about  certain  parts  of 
the  body ;  and  the  animals,  continuing  to  pass  blood,  die  in  a  state  of 
absolute  exhaustion,  without  apparent  suffering. 

This  termination  is  the  most  common,  unless  slaughter  is  determined 
on,  and  is  very  different  from  the  premature  end  which  follows  the  for- 
mation of  clots  and  obstruction  of  the  urethra. 

Externally  the  patients  only  show  feebleness,  pallor  of  the  visible 
mucous  membranes,  and  difSculty  in  urination.  The  bunch  of  hair  at 
the  lower  commissure  of  the  vulva  is  always  soiled  with  blood-stained 
urine  or  little  clots. 

Hematuria  may  cause  death  by  exhaustion  in  from  six  weeks  to  two 
months,  bat  not  infrequently  it  lasts  for  months  or  even   years. 

Diagnosis.  The  diagnosis  presents  no  difficulty  when  the  urine 
can  be  examined  ;  but  in  the  periods  of  intermittence  no  opinion  can 
be  advanced.  These  intermittences  are  so  frequent  that  in  parts  of 
the  country  ravaged  by  this  disease  it  is  a  usual  custom,  when  selling, 
to   grant  or  refuse  guarantees   for  a  longer  or  shorter  term. 

The  condition  can  be  distinguished  from  parasitic  hcemoglobinuria 
(piroplasmosis)  or  from  Brou's  disease  (a  febrile  disease  of  rapid  de- 
velopment) by  simply  examining  the  urine  or  blood. 

Prognosis.  The  prognosis  is  extremely  grave,  for,  up  to  the  pre- 
sent, no  really  efficacious  treatment  has  been  discovered,  and  although 
some  animals  may  live  for  years  without  their  lives  being  in  any  way 
endangered,  this  cannot  possibly  be  foreseen,  and  there  is  no  economic 
advantage  in  keeping  them. 

Treatment.     No  curative  treatment  is  known. 

It  is  true  that  iron  salts,  tonics,  Eabel's  liquid,  decoctions  of  cer- 
tain plants,  such  as  plantain,  have  been  recommended,  but  apart 
from  the  fact  that  they  are  of  doubtful  efficacy,  they  cannot  be  used 
over  long  periods.  All  these  preparations  also  tend  to  increase  the 
coagulability  of  the  blood  ;  but  considering  that  the  disease  is  beyond 
question  of  a  parasitic  character,  good  results  cannot  always  be  ex- 
pected of  them. 


526  DISEASES    OF   THE   BLADDER, 

Preventive  treatment  appears  more  hopeful,  although  even  in  this 
connection,  the  best  informed  appear  to  have  considerable  doubts. 
All  those  who  have  studied  the  question  agree  in  recommending 
drainage  of  the  pasturages,  and  their  improvement  by  the  use  of 
various  manures,  particularly  superphosphates  and  lime.  These 
improvements  alter  the  character  of  the  pasture,  render  the  soil 
healthier,  and  may  perhaps  prove  sufficient  to  diminish  or  prevent 
the  local  growth  of  the  germs.  Under  such  conditions,  Boudeaud 
declares  that  he  has  seen  haematuria  disappear  from  farms  where  it 
had  previously  been  in  permanent  possession.  It  has  also  been  re- 
commended that  the  affected  cattle  should  be  sent  elsewhere  to 
places  where  the  disease  does  not  exist,  and  experience  shows  that 
spontaneous  recovery  is  more  frequent  under  such  conditions. 

It  is  probable  that,  during  attacks  of  haematuria  in  a  contami- 
nated country,  successive  parasitic  infestations  occur,  which  would  ex- 
plain the  persistence  with  which  blood  is  j)assed,  a  symptom  which  does 
not  occur  in  a  healthy  country.  This  view,  however,  is  still  only 
an  hypothesis. 


CHAPTER    III. 
DISEASES    OF    THE    KIDNEYS. 

CONGESTION    OF    THE    KIDNEYS. 

Congestion  of  the  kidneys  is  not  a  morbid  condition  in  the  strict 
sense  of  the  term,  for  it  is  merely  the  forermmer  of  ne^^hritis  caused  by 
infections  diseases  or  intoxications  (primary  active  congestions)  or  the 
final  consequence  of  other  diseases,  such  as  diseases  of  the  heart  or 
liver,  mechanical  compression  of  the  vena  cava  or  renal  veins  (secon- 
dary passive  congestion,  cardiac  kidney). 

Nevertheless,  under  certain  circumstances  the  development  of  ne- 
phritis may  be  arrested  at  the  primary  congestive  stage,  and  it  is  only 
then  that  an  opportunity  occurs  of  studying  it  as  a  definite  complaint. 

Causation.  All  infections  accompanied  by  lesions  of  the  kidneys, 
and  these  are  numerous  (gangrenous  coryza,  anthrax,  parasitic  haemo- 
globinuria),  produce  congestion  of  the  kidneys. 

Cold  also  acts  directly  under  certain  conditions,  as  do  large  doses  of 
diuretics,  irritant  foods  the  principles  of  which  are  eliminated  through 
the  urine  (fermenting  or  putrid  sugar-pulp,  for  example),  and  foods  rich 
in  resins,  essential  oils,  various  glucosides,  tannin,  etc.  (young  shoots  of 
trees  during  the  spring-time). 

Symptoms.  The  symptoms  are  difficult  to  define  accurately,  and  the 
diagnosis  can  only  be  arrived  at  with  the  aid  of  the  history. 

Eenal  congestion  produces  pain,  indicated  by  dull  colic  and  repeated 
and  inefi'ectual  attempts  to  urinate,  suggesting  acute  cystitis.  The 
patients  lose  appetite,  and  present  all  the  general  symptoms  of  marked 
visceral  inflammation,  viz.,  fever,  acceleration  of  breathing,  somewhat 
tumultuous  action  of  the  heart,  etc. 

External  or  internal  examination  of  the  kidneys  reveals  abnormal 
sensitiveness.  The  urine  is  of  a  dark  or  bright-red  tint,  owing  to  the 
presence  of  red  blood  corpuscles.  These  blood  corpuscles  are  precipi- 
tated on  placing  the  fluid  in  a  tall  glass,  and  can  be  detected,  together 
with  renal  epithelium,  by  microscopic  examination. 

The  diagnosis  is  somewhat  difficult,  and  it  requires  very  careful 
attention  to  distinguish  between  congestion  of  the  kidney  and  true 
nephritis. 


528  DISEASES   OF   THE    KIDNEYS. 

The  prognosis  should  always  be  reserved  until  it  is  certain  that 
acute  nephritis   will  not  ultimatel}'  develop. 

The  treatment  consists  in  removing  the  cause  of  the  congestion  ; 
rich  foods,  or  foods  containing  irritant  principles,  should,  therefore,  be 
avoided,   as  also  the  administration  of  diuretics,  etc. 

Otherwise,  the  treatment  is  similar  to  that  employed  in  all  visceral 
inflammations :  bleeding  to  the  extent  of  two  to  four  quarts,  according 
to  the  size  of  the  animals,  w'arm  poultices  to  the  loins  and  flanks,  dry 
friction,  mucilaginous  drinks  and  emollient  decoctions  of  barley  or  pel- 
litory.     The  animals  should  be  kept  in  a  warm  place. 

In  cases  of  passive  and  secondary  congestion,  treatment  must  be 
directed  towards  improving  the  condition  of  the  organ  primarily  affected, 
whether  it  be  the  heart,  liver,  or  lymphatic  glands. 


ACUTE    NEPHRITIS. 

The  term  nephritis  applies  to  inflammation  of  the  renal  tissues. 
Clinically,  two  forms  only  can  be  distinguished,  the  acute  and  the 
chronic. 

As  regards  its  pathological  anatomy,  the  inflammation  may  princi- 
pally affect  either  the  interstitial  tissue  or  the  epithelial  parenchyma,  a 
fact  which  has  suggested  the  division  of  the  condition  into  epithelial 
nephritis,  interstitial  nephritis,  and  mixed  nephritis.  Clinically,  such 
distinctions  are  impossible ;  and  in  reality  all  forms  of  nephritis  are  to  a 
varying  degree  mixed,  the  lesions  predominating  in  one  or  other  of  the 
constituent  tissues.  These  lesions  depend  on  the  extent,  intensity,  and 
duration  of  the  inflammatory  attack,  whatever  the  primary  causes.  All 
the  constituent  tissues  of  the  kidney  may  be  affected,  simultaneously 
or  individually  :  the  Malpighian  corpuscles,  the  convoluted  tubules,  the 
collecting  tul)ules,  or  the  interstitial  connective  tissue. 

Causation.  Cold  seems  to  be  an  important  factor.  All  acute  or 
chronic  intoxications  in  which  the  toxic  principles  are  eliminated  by  the 
kidneys,  such  as  poisioning  by  cantharides,  fermented  beet  pulp,  young 
shoots  of  trees  or  toxic  plants,   may  cause  acute  nephritis. 

Infectious  diseases,  such  as  gangrenous  coryza,  haemoglobinuria, 
tuberculosis  and  post-partum  infections,  also  play  an  important  part, 
whether  the  nephritis  be  direct,  that  is  to  say,  the  result  of  the  infecting 
agent  itself,  or  indirect,  i.e.,  produced  by  toxins  generated  in  the  body. 
In  female  animals  gestation  is  an  often  unsuspected  cause,  Moussu 
believes  that  albuminuria  is  frequent  during  gestation,  and  although  in 
most  cases  it  is  only  of  moderate  degree,  he  thinks  it  is  often  associated 
with  sub-acute  nephritis,  which  might  be  aggravated  by  an  accidental 
cause. 


ACUTE    NEI'HRITIS.  529 

Many  forms  of  nephritis  are  overlooked  in  consequence  of  their  slight 
character. 

Symptoms.  The  early  symptoms  are  similar  to  those  of  congestion 
of  the  kidney,  viz.,  dull  colic,  excessive  sensitiveness  over  the  region  of 
the  loins,  passage  of  pink  urine,  loss  of  appetite,  and  fever.  At  a  later 
stage,  in  cases  of  acute  nephritis  due  to  cold,  the  animal  stands  with  the 
limhs  close  together  and  remains  stationary,  arching  the  loins  and  back, 
which  are  held  stifHy.  The  animal  obstinately  refuses  to  move  in  con- 
sequence of  the  pain  produced  by  so  doing. 

The  general  condition  becomes  grave,  respiration  is  rapid,  the  pulse 
frequent,  the  artery  tense,  the  muzzle  dry,  the  accessible  mucous  mem- 
branes are  injected,  and  appetite  is  almost  entirely  lost. 

Urine  is  frequently  passed,  but  the  act  causes  pain,  and  the  quan- 
tity is  small.     Absolute  anuria  is  rare,   and  does  not  last  long. 

The  urine  is  generally  sanguinolent,  at  least  at  first,  but  to  a  very 
varying  extent.  It  is  always  albuminous,  the  quantity  of  albumen 
varying  enormously,  and  on  microscopic  examination,  is  usually  found 
to  contain  red  and  white  blood  corpuscles,  epithelium  from  the  kidney 
hyaline  or  epithelial  cylinders,  and,  towards  the  end,  pus  corpuscles. 

(Edema  or  anasarca,  though  common  in  mankind,  does  not  occur  in  a 
very  marked  form,  except  in  intense  acute  nephritis.    Epistaxis  is  also  rare. 

Diagnosis.  The  diagnosis  requires  some  care,  because  unless  the 
urine  be  examined  the  symptoms  might  lead  to  error.  Nevertheless,  it 
is  always  possible  to  distinguish  between  this  condition  and  haematuria 
or  accidental  renal  haemorrhage. 

Prognosis.  The  prognosis  is  grave,  because  absolute  recovery  is 
rare,  and  because  the  condition  is  very  apt  to  become  chronic. 

The  degree  of  anuria  and  the  respiratory  difficulty  are  of  great 
service  in  confirming  the  prognosis.  As  soon  as  urine  is  freely  passed 
the  prognosis  becomes  more  favourable. 

Treatment.  Among  the  most  effective  methods  of  treatment  must 
be  included  bleeding,  which  always  produces  some  improvement.  Dry 
friction  over  the  kidneys  and  flanks,  hot  moist  applications,  and  the 
application  of  a  sheep-skin  to  the  loins  are  also  of  service.  Internally, 
mucilaginous  drinks,  diuretic  decoctions  and  milk  give  the  best  results. 
The  proportion  of  albumen  rapidly  diminishes,  dysuria  becomes  less 
marked,  urine  is  passed  in  greater  quantities,  and  in  from  eight  to  ten 
days  all  the  alarming  symptoms  disappear.  Bicarbonate  of  soda  may 
then  be  given  for  a  fortnight. 

In  very  grave  cases  camphor,  bromide  of  camphor,  injections  of 
camphorated  oil  (1  to  2J  drachms  internally,  or  1  to  1^  drachms  in 
subcutaneous  injections)  give  excellent  results  in  modifying  the  pain  and 
moderating  the  inflammation. 

D.C.  M  M 


530  DISEASES   OF   THE    KIDNEYS. 

From  I  to  1  drachm  of  digitalis  in  powder,  or  better  still  an  injection 
of  from  5  milligrammes  to  1  centigramme  of  digitaline  may  also  be  given 
when  dj'spncea  is  very  great  and  is  accompanied  by  anasarca.  Medicines 
such  as  oil  of  turpentine  and  considerable  doses  of  nitrate  of  potash, 
however,  are  contra-indicated. 

CHRONIC    NEPHRITIS 

True  chronic  nephritis,  i.e.,  a  condition  strictly  limited  to  the  renal 
tissue,  and  unaccompanied  by  pyelitis,  is  still  little  known  among  our 
domestic  animals.  The  symptoms  characterising  it  have  not  always 
been  carefully  no'ted,  and  the'  diagnosis  is  A^ery  often  uncertain.  Never- 
theless, one  of  the  most  common  forms  has  been  carefully  studied  by 
Seuffert,  viz.,  chronic  hypertrophic  nephritis. 

Causation.  Chronic  nephritis  is  the  common  sequel  to  the  acute 
forms,  whatever  their  origin,  but  it  may  also  occur  primarily  from 
repeated  chills  produced  by  such  conditions  as  exposure  to  heavy  con- 
tinued rain  when  at  grass,  chills  contracted  during  cold  nights  and 
the  great  variations  in  temperature  in  spring  and  autumn.  The  con- 
ditions, however,  thus  produced  are  rather  of  the  nature  of  subacute 
nephritis  than  of  chronic  nephritis,  properly  so  called. 

These  forms  of  chronic  nephritis  may  also  occur  primarily  in  con 
sequence  of  chronic  hepatic  lesions  with  pressure  on  the  posterior  vena 
cava,  producing  blood  stasis  in  the  kidneys.  Finally,  they  may  repre- 
sent the  delayed  effects  of  slight  lesions  which  have  escaped  notice  and 
have  developed  during  grave  diseases  or  as  a  consequence  of  repeated 
gestation. 

From  the  anatomico-pathological  standpoint,  the  only  conditions 
hitherto  recognised  are  the  chronic  hypertrophic  forms  of  nephritis 
(large,  white  sclerotic  kidney  with  lardaceous  degeneration  and  some- 
times marbling).  This  is  probably  because  the  animals  are  slaughtered 
as  soon  as  they  suffer  in  condition,  but  if  they  were  kept  long  enough 
they  would  undoubtedly  suffer  also  from  the  atrophic  chronic  forms  of 
nephritis  found  in  man  and  in  the  dog.  In  the  case  of  man  observation 
has  shown  that  these  two  forms  only  represent  different  stages  in  the 
development  of  one  disease,  the  large,  hypertrophied  kidney  of  the  early 
stages  afterwards  undergoing  marked  progressive  atrophy. 

The  symptoms  are  at  first  so  vague  that  diagnosis  would  be 
impossible  on  a  single  examination.  Seuffert  states  that  the  condition 
develops  as  follows : — 

The  first  sign,  loss  of  appetite,  is  soon  followed  by  constipation  and 
dull  colic,  due  to  congestion  of  the  kidney  ;  -the  pain  is  often  so  grep,t 
as  to  cause  intermittent  groaning. 


HYDRO-NEPHROSIS.  531 

The  urine  passed  is  always  turbid,  and  sometimes  blood-stained,  but 
this  staining  rarely  lasts  longer  than  a  week.  The  urine  then  gradually 
resumes  its  normal  appearance,  is  passed  in  small  quantities,  and  con- 
tains more  or  less  albumen.  The  yield  of  milk  markedly  and  progres- 
sively diminishes. 

If  treatment  is  resorted  to  at  this  stage  laxatives  and  diuretics 
appear  to  effect  a  real  improvement.  Unfortunately,  however,  the 
apparent  improvement  is  but  temporary  ;  the  kidneys  become  hyper- 
trophied,  and  the  right  soon  occupies  the  whole  of  the  sublumbar 
space,  its  margin  extending  as  far  as  the  extremity  of  the  transverse 
processes  near  the  anterior  angle  of  the  hollow  of  the  flank. 

This  hypertrophy  and  the  extreme  sensitiveness  can  be  detected 
by  external  palpation.  Internal  examination  confirms  the  facts  so 
observed  as  regards  both  the  kidneys. 

The  patients  eat  little  and  become  thin,  whatever  treatment  be 
adopted.  They  progressively  waste,  and  die  after  some  months  in  a 
state  of  marasmus,  exhausted  and  intoxicated. 

It  is  very  probable  that  the  digestive  disturbances  are  complicated 
by  respiratory  and  cardiac  trouble,  as  in  man  and  the  dog  ;  but  neither 
cardiac  nor  uraemic  disease  of  the  kidney  has  been  recorded. 

Diagnosis.  When  the  urine  is  analysed  the  diagnosis  becomes  com- 
paratively easy.  Persistent  albuminuria  and  hypertrophy  of  the  kidneys 
during  the  early  stages  are  significant  indications.  There  can  be  little 
hesitation  except  in  so  far  as  i^yelo-nephritis  and  hydro-nephrosis  are 
concerned,  but  the  conditions  are  distinguished  by  the  character  of  the 
urine  in  the  two  latter  cases,  together  with  the  condition  of  the  pelvis 
of  the  kidney,  and  of  the  ureters. 

Prognosis.  The  prognosis  is  grave,  and  Seuffert  believes  that  re- 
covery never  occurs.  This  is  also  true,  generally  speaking,  as  regards 
all  forms  of  chronic  nephritis. 

Treatment.  As  the  disease  must  be  regarded  as  incurable  there  is 
really  no  justification  for  treatment.  Nevertheless,  if  for  special  reasons 
the  owner  wishes  to  keep  the  animals  for  a  certain  time,  as  in  the 
case  of  a  cow  near  its  time  of  calving,  recourse  may  be  had  to  the 
internal  treatment  suggested  in  acute  nephritis,  viz.,  mucilaginous 
drinks,  diuretic  infusions,  milk,  bicarbonate  of  soda,  stimulating 
applications  to  the  loins,  etc. 

HYDRO-NEPHROSIS. 

Hydro-nephrosis,  i.e.,  retention  of  urine  in  the  pelvis  of  the  kidney 
and  in  the  collecting  and  secreting  tubules,  is  a  somewhat  common 
malady  of  the  bovine  species.     It  is  usually  confined  to  one  kidney. 

M  M    2 


532 


DISEASES   OF   THE   KIDNEYS. 


Causation  Anything  wliich  obstructs  the  discharge  of  urine  through 
the  ureters  may  cause  hydro-nephrosis.  Thus,  vesical  tumours  pressing 
on  the  orifices  of  the  ureters,  calculi  which  have  become  fixed  in  them, 
torsion  or  "  kinking  "  of  the  ureters,  may  bring  about  hj'dro-nephrosis. 
The  urine  secreted  by  the  kidney  being  unable  to  escape,  accumulates 
in  the  pelvis  of  the  kidney,  in  the  ureter,  and  uriniferous  tubules, 
producing  dull  colic,  which  escapes  observation,  or  the  exact  cause  of 
which  is  not  discovered,  because  the  second  kidney  vicariously  acts  for 
the  one  affected,  and  urination  continues  regularly.  Secretion  continu- 
ing in  spite  of  the  ob- 
struction, that  portion  of 
the  ureter  above  the  ob- 
structed point,  together 
with  the  pelvis  and 
the  uriniferous  tubules, 
gradually  becomes  di- 
lated, until  the  whole 
mass  of  the  kidney  is 
hypertrophied. 


Fig.  228. — Hydro-nephrosis  of  the  kidney. 


The     ureter     some- 
times becomes  enlarged 
to  the  size  of  a  man's 
L   '^'^  ^^-/^  ^JF       arm,  the  kidney  double, 

\  ?^*'-— --Ksr— -..^^      '       ,,        -  -""^g  treble,  or  quadruple  its 

normal  side  :  the  inter- 
lobular divisions  are 
lost,  and  each  circum- 
scribed lobule  soon 
forms  a  cystic  cavity 
varying  in  size.  The 
pressure  due  to  the  accumulated  urine  causes  the  renal  tissue,  first  the 
medullary  substance  and  afterwards  the  peripheral  zone,  to  undergo 
atrophy. 

The  kidney  is  represented  by  a  vast  C3\stic  cavity,  and  the  lobules 
by  culs-de-sac ;  the  cortical  layer  may  become  atrophied  to  such  a 
degree  as  to  form  merely  a  fibrous  sheath,  the  primary  constituent 
elements  of  which  are  difficult  to  discover.  From  20  to  40  pints  of 
liquid  may  sometimes  be  found  in  the  cystic  kidney. 

Diagnosis.     The  condition  is  rarely  diagnosed,  because,  as  one  of  the 

kidneys  contiinies  to  act,  no  acute  disturbance  follows.     Only  in  cases 

where  the  cystic  kidney  projects  into  the  flank  are  suspicions  aroused. 

Examination  per  rectum  will  then  permit  of  the  diagnosis  being  made. 

Prognosis.     Hydro-nephrosis     being,     as    a     rule,    unilateral,    the 


Infections  pi^Ei-o-NEPHRltis, 


533 


prognosis  is  not  very  grave  as  regards  immediate  danger.  As  the 
condition  is  hopeless,  however,  the  lesions  being  irreparable,  the 
animal  should  be  prepared  for  slaughter. 

Treatment.  Practically  there  is  no  treatment.  Puncture  of  the 
cystic  cavity  or  even  the  removal  of  the  hydro-nephrotic  kidney  cer- 
tainly suggests  itself,  but,  as  such  operations  are  usually  opposed  to 
the  interests  of  the  owner,  they  are  rarely  or  never  practised. 

INFECTIOUS    PYELONEPHRITIS. 

The  term  "  infectious  pyelo-nephritis "  describes  an  inflammation 
which    may  involve   any    portion    of    the    mucous    membrane    of    the 


Fig.  229. — Section  of  a  kidney  affected  with  hydro-nephrosis.     The  gland  substance 
is  ahiiost  entirely  atrophied,  and  each  lobule  shows  marked  dilatation. 


urinary  tract,  and  which  is  produced  by  a  special  bacillus.  As  a 
rule,  this  inflammation  commences  in  the  mucous  membrane  of  the 
calices  and  pelvis  (pyelitis).  It  afterwards  extends  into  the  depths 
of  the  uriniferous  canaliculi  (nephritis),  but  in  grave  and  old-stand- 
ing cases  the  mucous  membrane  of  the  ureters  and  the  bladder  may 
also  be  affected.  The  disease  had  long  been  known  in  France 
(Rossignol,  1848).  It  was  afterwards  described  in  Germany  (Siedam- 
grotski,  1875;  Pflug,  1876),  in  Switzerland  (Hess,  1888),  and  also  in 
France  (Lucet,  1892;  Masselin  and  Porcher,  1895). 

Causation.  Female  animals  are  more  frequently  affected  than 
males,  because  the  lesions  are  produced  by  an  ascending  infection, 
originating  very  frequently  in  genital  infection  after  delivery.     Never- 


53-1  DISEASES    OF*   THE    IvIDNEYS. 

theless,   calculus   formation  is  also   an  important  factor  in  producing 
the  disease. 

Many  different  agents  are  capable  of  producing  pyelo-nephritis. 
Hoftiich  in  1891  described  a  bacillus  about  2  to  3  micromillimetres 
in  length,  which  stained  readily  with  aniline  colours  and  with  Gram 
solution.  Lucet  in  1892  found  a  short  bacillus  which  did  iiot  stain 
with  Gram,  and  later  another  thin  bacillus  which  did.  Kitt  has 
described  cocci,  but  no  other  organisms.  Masselin  and  Porcher  dis- 
covered a  cocco-bacillus  which  stained  with  Gram  and  reproduced 
the  disease  in  an  animal  lent  by  Moussu,  after  a  single  intra-vesical 
injection  of  the  culture.  Cadeac  has  met  with  staphylococci,  and 
Moussu  has  discovered  various  bacilli,  some  resembling  the  colon 
bacillus,  and  pyogenic  streptococci. 

There  is  no  -doubt  that  many  different  organisms  may  produce 
pyelo-nephritis  by  ascending  infection.  The  most  common  seem  to 
be  forms  of  paracoli,  such  as  the  Bacillus  urcce.  Moussu  nevertheless 
believes  that  Hofflich's  bacillus,  which  was  rediscovered  by  Porcher,  is 
that  which  produces  typical  pyelo-nephritis.  It  grows  in  the  bladder 
without  producing  cystitis,  and  is  succeeded  by  an  ascending  infec- 
tion of  the  ureters  without  causing  primary  ureteritis,  the  local  inflam- 
mation occurring  chiefly,  it  would  seem,  in  the  pelvis  and  the  kidney. 
All  the  other  organisms  which  Moussu  has  tested  have  caused  lesions 
of  cystitis  and  of  ureteritis,  together  with  those  of  pyelo-nephritis. 

In  these  latter  cases  the  pyelo-nephritis  assumes  the  acute  form, 
and  is  accompanied  not  infrequently  by  cellulitis  and  abscess  forma- 
tion in  the  tissue  around  the  kidney. 

Symptoms.  Pyelo-nephritis  develops  in  one  of  two  principal  forms, 
the  slow  chronic  form,  which  is  the  most  frequent,  or  an  acute  or 
subacute  form,  much  more  rapid  in  its  development. 

The  chronic  form  for  a  time  escapes  notice.  There  is  no  doubt 
that  at  first  some  general  disturbance  occurs,  such  as  diminution  of 
appetite,  disturbed  nutrition,  unhealthy  general  appearance,  staring 
of  the  coat,  tightness  of  the  hide,  wasting,  etc.,  but  such  symptoms 
are  in  no  wise  characteristic,  being  found  in  all  grave  diseases. 

The  signs  only  become  really  significant  from  the  clinical  standpoint 
when  tbe  urine  appears  modified  in  character,  and  such  modification 
does  not  occur  until  the  pelvis  of  the  kidney  and  the  kidneys  them- 
selves are  already  gravely  diseased. 

The  urine  is  then  turbid,  of  a  brownish  colour,  and  charged  with 
sediment,  filaments  of  mucin,  pus  corpuscles,  and  earthy  phosphates. 
On  analysis  it  is  found  to  contain  more  or  less  albumen. 

At  a  late  stage  it  may  even  become  glairy,  blood-stained,  or  of 
the  colour  of  blood,  and  when  the  pelvis  or  the  calices  of  the  kidney 


INFECTIOUS   PYELO-NEPHRlTlS. 


535 


r 


Fig.  230.— Pyelo-neplu-itis  with  hsemorrhagic  pyo-iiephrosis  of  one  side.     One  ureter 
is  dilated  and  blocl^ed  with  a  blood  clot. 


536  DISEASES   OF   THE   KIDNEYS, 

are  ulcerated  may,  on  standing,  deposit  considerable  quantities  of  red 
blood  coriDuscles. 

Exi^osed  to  the  air,  the  urine  rapidly  assumes  a  brown  tint  and 
smells  strongly  of  ammonia. 

Percussion  of  the  loins  in  the  region  of  the  kidneys  causes  pain,  as 
does  external  palpation  by  the  flank.  On  rectal  examination  at  this 
period  the  ureters  are  found  to  be  distended  and  hard,  and  they  give 
the  impression  of  rigid  or  bosselated  fibrous  cords,  sometimes  as  large 
as  a  child's  arm.  The  corresponding  kidney,  often  both  kidneys,  are 
enlarged,  sometimes  to  double  or  treble  their  normal  volume,  and  are 
painful  on  pressure  and  fluctuating,  at  least  in  the  region  of  the  pelvis. 
On  vaginal  examination  the  meatus  urinarius  is  usually  found  to  be  in- 
flamed, rough  and  turgid. 

In  this  condition  the  animals  rapidly  lose  flesh,  the  appetite  becomes 
irregular,  the  general  condition  gradually  gets  worse,  and  they  die  as  a 
result  of  continued  uro-septic  fever  or  ursemic  troubles. 

The  acute  form  takes  a  much  more  rajDid  course,  with  fever,  more 
marked  general  disturbance,  acceleration  of  pulse  and  breathing,  the  pas- 
sage of  turbid  and  sometimes  purulent  urine  with  a  strong  ammoniacal 
smell.  Pyo-nephrosis  is  the  most  frequent  and  characteristic  end.  Ordi- 
nary chronic  pyelo-nephritis  may  also  occur  in  these  cases,  and  the  acute 
course  may  be  determined  simply  by  accidental  ascending  infections. 

Diagnosis.  During  the  early  stages  diagnosis  is  extremely  difficult, 
unless  a  careful  examination  of  the  urine  be  made.  Afterwards  it  becomes 
easy,  the  appearance  of  the  urine  and  the  indications  furnished  by 
rectal  exploration  being  perfectly  characteristic.  In  very  exceptional 
cases  there  may  be  some  doubt,  as  where  the  urine  remains  normal,  in 
spite  of  hydro-nephrosis,  or  where  there  is  old-standing  heematuria  or 
renal  tuberculosis.  In  simple  hsematuria  the  lesions  are  confined  to  the 
bladder  and  ureters,  the  kidneys  not  being  affected,  and  in  renal  tuber- 
culosis the  diagnosis  can  always  be  confirmed  by  the  use  of  tuberculin. 

Prognosis.  The  prognosis  is  extremely  grave,  for  the  lesions  pro- 
duced are  irreparable,  and,  moreover,  local  intervention  is  imi^ossible. 

Treatment.  There  is  no  curative  treatment.  All  that  is  possible  is 
palliative  treatment  with  the  object  of  facilitating  the  function  of  the 
kidney  and  of  disinfecting  the  urinary  passages  by  administering  anti- 
septic substances  which  are  excreted  by  the  kidney.  It  is  not  possible, 
however,  to  administer  active  drugs  of  this  kind  {e.g.,  combinations  of 
carbolic  acid).  As  the  kidney  acts  badly  it  soon  ceases  to  eliminate  such 
substances,  and  the  condition  would  not  be  improved,  but  aggravated. 

Benzoate  of  soda  in  doses  of  2  to  2^  drachms  per  day  dissolved  in 
diuretic  liquids  is  the  most  useful  drug,  and  sometimes  holds  the  disease 
in  check  for  a  sufficient  time  to  allow  of  the  animals  beine:  fattened. 


SUPPURATIVE   NEPHRITIS    AND    PERINEPHRITIS.  537 

Treatment  also  comprises  certain  prophylactic  precautions.  As  the 
infection  which  produces  pyelo-nephritis  originates  in  the  genital  tract, 
it  is  desirable  to  protect  all  animals  in  a  receptive  condition  (those  about 
to  calve  or  having  recently  calved)  from  infection  ;  hence,  when  the 
disease  is  detected  in  a  cow-shed,  the  patients  should  be  isolated,  and 
the  shed  thoroughly  disinfected. 


SUPPURATIVE    NEPHRITIS    AND    PERINEPHRITIS. 

Suppuration  of  the  kidney  may  occur  under  two  conditions.  In  the 
majority  of  cases  such  suppuration  occurs  as  a  complication  of  pyelo- 
nephritis ;  less  frequently  it  is  the  consequence  of  infection  from  within 
or  infection  of  adjacent  parts,  leading  to  the  formation  of  an  abscess. 

When  it  results  from  an  ascending  infection  the  kidney  becomes 
swollen,  congested  and  inflamed,  and  soon  displays  localised  minute 
haemorrhages.  Pus  then  forms  within  the  calices,  in  the  large  straight 
tubes,  and  diffuse  suppuration  invades  all  the  uriniferous  tubules.  The 
enlarged  kidney  is  yellowish,  firm  under  the  knife,  and  when  sections  are 
compressed  pus  exudes  from  the  openings  of  the  tubular  canaliculi. 

When  suppurative  nephritis  has  resulted  from  accidental  infection 
of  internal  origin,  an  abscess  is  found  to  have  produced  more  or  less 
extensive  atrophy  of  a  portion  of  the  kidney  while  not  affecting  the  rest 
of  the  organ. 

It  is  only  in  those  favourable  cases  where  the  renal  abscess  opens 
into  the  pelvis  that  suj)puration  may  invade  the  whole  of  the  kidney, 
producing  diffuse  suppurative  nephritis  by  secondary  infection  of  the 
uriniferous  tubules.  Such  complications  are  rare.  Usually  the  abscess 
empties  through  the  pelvis,  and  recovery  may  occur. 

More  frequently  suppurative  pyelo-nephritis  develops,  together  with 
ureteritis,  cystitis,  dilatation  of  the  ureters,  dilatation  of  the  pelvis  of 
the  kidney,  and  dilatation  of  the  collecting  tubules  of  the  pyramids,  the 
final  stage  resembling  the  lesions  of  pyo-nephrosis. 

Perinephritis  and  perinephritic  cellulitis,  i.e.,  inflammation  with  or 
without  abscess  formation  in  the  connective  tissue  and  adipose  layer 
surrounding  the  kidney,  always  occur  in  cases  of  suppurative  nephritis 
or  pyelo-nephritis.  Such  inflammations  may  also,  in  exceptional  cases, 
follow  direct  mechanical  injury,  but  they  almost  invariably  represent 
complications,  the  organisms  infecting  the  kidney  passing  through  the 
tissues  and  the  layer  of  fibrous  tissue,  or  extending  by  the  lymphatic 
paths,  finally  attaining  the  fatty  tissue  surrounding  the  kidney  and  there 
undergoing  multiplication.  The  fatty  tissue  is  infiltrated  with  reddish 
serosity,  is  inflamed,  and  may  become  the  seat  of  large  abscesses  com- 
municating with  or  separate  from  the  abscesses  of  the  kidney  itself. 


538 


DISEASES   OF   THE   KIDNEYS. 


Symptoms.  Suppurative  nephritis  is  characterised  by  fever,  loss 
of  appetite,  arrest  of  rumination,  and  frequent  attempts  to  urinate. 
These  attempts  are  painful,  are  accompanied  by  groaning,  and  end  in 
the  passage  of  an  insignificant  quantity  of  blood-stained  and  purulent 
urine. 

Palpation,  more  especially  palpation  of  the  right  flank,  percussion 
over  the  region  of  the  loins,  and  examination  of  the  kidneys  through  the 
rectum  are  painful.     Wasting  is  rapid. 

If  the  suppurative  nephritis  develops  rapidly,  and  particularly  if  it  be 
accompanied  by  perinephritis,  the  patients  refuse  to  rise  and  appear  to 
be  suffering  from  paraplegia,  although  not  really  so,  both  sensation  and 
motor  power  persisting  in  a  greater  or  less  degree.  Probably  the  condi- 
tion is  accompanied  by  reflex  pain  and  irritation  of  the  nerve-trunks  of 
the  lumbo-pubic  plexus. 

On  the  other  hand,  when  suppurative  nephritis  tends  to  develop 
slowly  and  assume  a  chronic  form,  lesions  of  pyo-nephrosis  gradually 


Fig.  231. — Leaf  lard  around  kidney  of  pig. 

develop,  and  are  identical  in  appearance  with  those  of  hydro-nephrosis, 
except  that  the  ureters,  the  pelvis  and  the  dilatations  corresponding  to 
the  lobules,  are  filled  with  pus. 

Diagnosis.  The  diagnosis  is  not  very  difficult.  The  urinary  trouble 
and  the  composition  of  the  urine  itself  always  arouse  suspicion.  The 
diagnosis  is  confirmed  by  careful  and  methodical  examination  pt''"  rectum  ,• 
the  inflammation  of  the  fatty  tissue  surrounding  the  kidney  can  usually 
be  detected. 

Prognosis.  The  prognosis  is  extremely  grave,  and  almost  always 
fatal,  particularly  in  cases  of  diffuse  nephritis. 

Treatment.  No  curative  treatment  can  be  absolutely  relied  on. 
Treatment,  if  attempted,  is  limited  to  the  methods  suggested  for  pyelo- 
nephritis. Mucilaginous,  emollient,  and  diuretic  drinks,  and  daily  doses 
of  2  to  3  drachms  of  benzoate  of  soda  given  in  the  drinking  water,  cause 
some  improvement. 


THE   KiDNliY    WORM    (SCLEKOSTOMA   PINGUICOLA)    OF   SWINE,         539 


Stimulation  of  the  region  of  the 
loins  also  undoubtedly  has  a  favour- 
able effect,  and  should  always  be 
practised,  particularly  where  peri- 
nephritis is  developing.  It  may  check 
the  course  of  the  disease  and  pre- 
vent the  formation  of  abscesses.  On 
slaughtering  animals  suffering  as 
above  described  the  layer  of  tissue 
surrounding  the  kidney  is  found  to 
be  lardaceous  and  fibro-fatty. 

Any  treatment  through  the  bladder 
is  contra-indicated,  for  even  the  pas- 
sage of  a  catheter  may  cause  severe 
injury  of  the  urethra  or  the  vesical 
mucous  membrane  and  produce  a 
fatal  aggravation. 

If  these  conditions  are  diagnosed 
early,  while  the  function  of  the  kidney 
is  more  or  less  preserved,  and  if  the 
animal  is  still  in  good  condition,  it 
should  be  slaughtered. 

THE     KIDNEY     WORM      (SCLEROS- 
TOMA  PINGUICOLA)  OF  SWINE.* 

In  the  United  States  of  America  a 
worm  is  frequently  found  in  the  fat 
surrounding  the  kidneys  of  pigs,  and 
is  supposed  by  farmers  to  be  the  cause 
of  paralysis  of  the  hind  limbs. 

This  so-called  kidney  worm  of 
hogs  {Sclerostoma  piiuinicola)  should 
not   be  confounded  with   the  kidney 

*  From  Eeport  of  the  U.S.A.  Bureau 
of  Animal  Industry,  1899,  p.  612.  (Louise 
Taylor.) 

Fig.  232. — Sclerostovia  innguicola.  External 
view  of  female,  a,  Male,  natural  size  ;  h,  fe- 
male, natural  size  ;  r,  mouth ;  cl,  buccal 
cavity  ;  e,  oesophagus  ;  /,  intestine ;  g,  anus  ;  7;, 
genital  opening  ;  i,  genital  tract ;  h,  cephalic 
gland.  (Louise  Taylor,  Annual  Report,  Bureau 
of  Animal  Industrv,  1899,  p.  614.) 


540 


DISEASES   OF   THE    KiDNEV.S. 


worm  [Dloctophiime  riscerale)  of  dogs  and  man.  Both  of  these  parasites 
belong  to  the  same  zoological  family  (Strongylidse),  but  to  different  sub- 
families and  genera.  The  kidney  worm  of  dogs  grows  to  a  length  of 
1  to  3  feet.  The  kidney  worm  of  hogs  is  much  smaller,  attaining  at 
most  something  less  than  2  inches  in  length. 

The  body  of  the  worm  is  plump,  mottled  in  color — red,  yellow,  white, 
black— according  to  the  organs  visible  beneath.  The  average  female  is 
about  37  mm.  and  the  average  male  32  mm.  in  length.  The  worms 
seem  to  occur  in  pairs,  usually  in  cysts  or  canals ;  thus,  upon  the  exami- 
nation of  two  kidneys  with  their  surrounding  fat,  fifteen  specimens  were 


Fig.  233. — Embryos  of  Sclerostoma  inngiiicola.     (Louise  Taj'lor,  Annual 
Eeport,  U.S.A.  Bureau  of  Animal  Industry,  1899,  p.  634.) 


found,  seven  males  and  eight  females.  The  connective  tissue  layers 
between  the  fat  were  found  to  be  the  most  general  seat  of  infection,  and 
the  cysts  were  numerous  and  closely  packed  together.  Although  a  cyst 
usually  contained  two  worms,  a  male  aiid  a  female,  sometimes  three  were 
found  together,  two  females  and  one  male,  or  just  as  often  one  female 
and  two  males.     The  cysts  contained  pus,  which  bathed  the  parasites, 

Still, 


THE    KIDNEY    WORM    (SCLEROSTOMA    PINGUICOLA)    OF    SWINE.         541 

other  C3^sts,  upon  being  cut  into,  were  found  without  parasites  and  in  a 
necrotic  condition. 

It  will  be  noticed  that  Sclerostoma  pingidcola  is  colloquially  known  as 
the  kidney  worm.  In  no  case,  however,  has  Miss  Taylor  found  it  in  the 
kidney  substance,  but  only  in  the  tissue  surrounding  this  organ  ;  the 
lard  appears  to  be  its  normal  habitat,  at  least. 

Just  how  the  eggs  leave  the  kidney  fat  or  enter  the  bodies  of  fresh 
hogs  has  not  been  demonstrated,  but  it  does  not  seem  unreasonable  to 
suppose  that  they  eventually  find  their  way  out  with  the  urine.  Indeed, 
Dean  reports  eggs  found  in  the  urine.  From  analogy  one  is  led  to 
believe  that  no  intermediate  host  is  required,  but  that  in  all  probability 
the  embryos  develop  for  a  short  time  in  water,  casting  several  skins, 
and  they  eventuallj'  gain  access  to  the  hogs  either  through  contaminated 
drinking  water  or  food. 

Because  of  the  hog's  habits,  it  is  difficult  to  see  any  practical  measures 
which  can  be  adopted  to  prevent  infection.  Feeding  from  troughs 
and  supplying  plenty  of  pure  drinking  water  will  decrease  but  not 
exclude  the  disease.  Leuckart's  advice  to  the  Germans,  "  Swine  should 
be  kept  in  a  less  swine-like  manner,"  holds  good  in  all  countries  and  in 
connection  with  all  diseases.  It  is  equally  impossible  to  suggest  prac- 
tical methods  of  treatment.  This  is  all  the  more  true  because  it  seems 
probable  that  a  number  of  distinct  complaints  are  popularly  grouped 
together  by  the  farmer  as  kidney-worm  disease. 


CHAPTER    IV 
GENITAL    APPARATUS. 

Semiology.  The  examination  of  the  genital  apparatus  properly  so 
called  is  easy  in  animals  of  large  size,  whether  male  or  female,  but  is 
more  delicate  and  difficult,  and  is  sometimes  partially  impossible,  in 
small  creatures. 

In  male  animals  it  comprises  the  examination  of  the  testicles  by 
inspection  and  palpation,  of  the  vas  deferens,  and  of  the  intra-pelvic 
genital  organs  (vesiculse  seminales,  prostate,  etc.). 

Inspection  and  palpation  of  the  scrotum  reveals  hypertrophy, 
atrophy,  oedematous  or  sanguineous  infiltrations,  inflammation  of  the 
tunica  vaginalis,  and  tumours  of  the  testicle.  Intra-pelvic  examina- 
tion partly  covers  the  same  ground  as  examination  of  the  pelvic 
portion  of  the  urethra,  and,  provided  the  anatomical  relationships  of 
the  different  organs  encountered  are  known,  there  is  no  difficulty  in 
detecting  the  position  of  possible  lesions  (Fig.  226). 

In  small  male  animals,  such  as  he-goats  and  rams,  rectal  exploration 
is  confined  to  the  use  of  one  or  two  fingers. 

In  female  animals  examination  comprises  inspection,  intra-vaginal 
examination,  and  rectal  examination. 

Inspection  reveals  lesions  of  the  vulva  and  clitoris. 

Vaginal  examination  with  the  hand  establishes  the  condition  of  the 
walls  of  the  vagina,  the  neck  of  the  uterus,  and  the  vaginal  culs-de-sac. 

If  a  lesion  is  detected,  its  character  can  easily  be  ascertained  by 
means  of  a  speculum,  which  exposes  the  base  of  the  vagina,  the  promi- 
nence formed  by  the  uterus,  or  any  particular  part  of  the  vagina  itself. 
Examination  with  the  speculum  is  the  only  useful  method  in  young 
female  animals,  heifers  in  particular,  on  account  of  the  narrowness 
of   the  genital  tract. 

In  small  female  animals,  such  as  she-goats,  ewes  and  sows,  the 
fingers  alone  can  be  employed. 

As  regards  examination  of  the  uterus,  the  direct  method  gives  little 
exact  information,  and  examination  by  the  rectum  is  to  be  preferred. 
By  passing  the  arm  into  the  rectum  and  gently  pressing  downwards 
towards   the  base  of  the  pelvis,   the  hand   can  be  brought  in  contact 


VAGINITIS.  543 

with  the  body  of  the  uterus,  which  can  be  moved  and  displaced  from 
right  to  left ;  the  horns  of  the  uterus  can  be  felt  and  followed  from 
the  body  of  the  uterus  as  far  as  the  Fallopian  tubes  and  the  ovaries. 
By  this  means  the  state  of  the  uterus,  its  degree  of  sensitiveness  and 
mobility,  as  well  as  the  state  of  the  Fallopian  tubes  and  of  the  ovaries, 
can  all  be  ascertained.     The  examination  also  reveals  the  existence  or 


Fig.  234. — Genital  organs  in  a  cow,  showing  the  anatomical  relations.  E,  Rectum  ; 
Gr,  meso-rectal  lymphatic  glands  ;  U,  ureter;  LL,  broad  ligament;  \a,  vagina; 
V,  bladder  ;  Cn,  uterine  cornu;  O,  ovary  ;  F,  Fallopian  tube. 

non-existence  of  gestation,  during  which  the  uterus  becomes  hyper- 
trophied  and  is  displaced  in  a  forward  direction  towards  the  right 
flank,  at  the  same  time  descending  in  front  from  the  base  of  the 
pelvis  over  the  abdominal  wall  and  under  the  mass  of  the  intestinal 
convolutions. 

VAGINITIS. 

Inflammation  of  the  vaginal  conduit  may  be  primary  or  secondary. 
It  usually  follows    difficult   parturition,  but  may  occur   under  various 


544  GENITAL   APPARATUS. 

circumstances.  From  the  clinical  standpoint  three  varieties  are  dis- 
tinguished :  simple  or  contagious  acute  vaginitis ;  croupal  vaginitis  ; 
and  chronic  vaginitis. 

ACUTE    VAGINITIS. 

Causation.  Deep-seated  genital  injuries  leading  to  metritis,  exces- 
sive and  prolonged  strains  due  to  painful  labours,  accidental  injuries 
caused  by  obstetrical  operations,  etc.,  are  followed  by  more  or  less 
acute  vaginitis. 

Sui:)purative  inflammation  of  Gartner's  canals,  irritant  and  caustic 
injections,  and  foreign  bodies  likewise  cause  local  irritation,  which  may 
become  complicated  by  infection  and  eventually  produce  vaginitis.  The 
infective  organisms  may  be  numerous  and  varied. 

Symptoms.  The  vagina  being  closed  to  external  inspection,  the 
symptoms  are  not  very  apparent.  At  first,  acute  vaginitis  is  sug- 
gested by  swelling  of  the  vulva,  pruritus,  and  dysuria.  The  lips 
of  the  vulva  are  oedematous,  injected,  sensitive  and  of  a  brownish- 
red  or  violet-red  colour  on  the  internal  surface.  Sometimes  they 
are  excoriated  and  torn. 

The  period  of  full  development  is  accompanied  by  the  escape  from 
the  vulva  of  a  serous,  mucous,  muco-purulent  or  purulent  discharge 
of  varying  odour.  Urination  is  painful  and  defsecation  difficult.  Ex- 
amination of  the  vagina  by  means  of  a  speculum  shows  the  mucous 
membrane  to  be  excoriated,  ultra-sensitive,  ulcerating  or  suppurating  at 
certain  points.     The  parts  are  hot. 

The  general  symptoms  are  little  marked,  and  without  importance. 
The  usual  termination  consists  either  in  recovery,  which  may  be  spon- 
taneous, or  in  passage  to  the  chronic  form. 

The  diagnosis  is  easy,  and  the  prognosis  favourable,  provided  the 
vaginitis  has  not  been  caused  by  severe  mechanical  injuries,  capable 
of  setting  up  cellulitis  or  the  formation  of  deep  abscesses  of  the  pelvis. 

Treatment.  One  of  the  principal  reasons  why  vaginitis  persists  is 
the  retention  of  morbid  products  in  the  vaginal  culs-de-sac.  Treat- 
ment ought  therefore  to  aim  chiefly  at  removing  these  by  soothing, 
astringent,  and  antiseptic  injections.  Soothing  injections  should  first 
be  tried.  They  consist  of  lukewarm  water  at  body  temperature, 
decoctions  of  black-cherry  bark,  poppy-heads,  linseed,  etc.  After  a 
few  days,  when  the  excessive  sensibility  has  disappeared,  antiseptic 
and  astringent  solutions  may  be  used,  such  as  crystallised  alum,  150 
grains  to  the  pint ;  sulphate  of  zinc,  75  grains  to  the  pint ;  carbolic 
acid,  lysol,  cresyl,  etc.,  150  grains  to  the  pint. 

Injections  of  permanganate  of  potash  of  the  strength  of  150  grains 
to  the  pint  and  of  solutions  of  iodine  at  a  strength  of  1  in  2,000  are 


CROUPAL   VAGINITIS.  545 

more  active,  but  require  more  careful  handling.  Hydroxyl  diluted 
with  from  3  to  5  parts  of  water  is  also  of  great  efficacy.  Strong 
solutions  should  never  be  used,  because  they  cause  irritation  and  ex- 
jmlsive  efforts. 

All  these  injections  may  be  made  without  difficulty  by  passing  a 
simple  perforated  drainage  tube  to  the  end  of  the  vagina,  and  con- 
necting it  with  a  syringe,  or,  better,  with  a  small  cistern  hung  from 
the  wall,  which  allows  the  required  pressure  to  be  obtained. 

When  there  are  deep  and  severe  wounds,  the  parts  should  be  washed 
out  once  or  twice  daily  and  the  vagina  should  be  packed  with  surgical 
wool  and  iodoform  gauze.  The  septic  liquids  are  absorbed  by  the 
dressing,  which  acts  continuously.  This  dressing  is  renewed  until  re- 
covery takes  place. 

CONTAGIOUS    VAGINITIS. 

During  the  past  few  years  certain  observers  have  described  a  disease 
which  has  been  termed  "contagious  vaginitis,"  in  consequence  of  the 
facility  with  which  it  is  transmitted. 

This  vaginitis  may  be  transmitted  by  copulation,  the  bulls  then 
serving  as  propagators  of  the  disease.  The  bulls  themselves  are  usually 
affected  with  balanitis. 

The  causative  agent  of  the  disease  is  unknown. 

This  contagious  vaginitis  is  characterised  by  all  the  symptoms  of 
acute  vaginitis,  and  it  is  only  from  the  fact  of  its  appearing  in  all  the 
animals  served  by  one  bull  that  its  contagious  character  is  established. 
A  short  time  after  service  the  vulva  appears  swollen  and  extremely 
sensitive ;  at  the  same  time  general  disturbance  appears,  viz.,  diminu- 
tion of  appetite  and  of  milk  secretion,  slackening  of  rumination,  etc. 

Vaginal  exploration,  which  is  somewhat  difficult,  reveals  a  papulo- 
vesicular eruption,  accompanied  by  a  muco-purulent  discharge. 

This  vaginitis  is  easy  to  diagnose.  It  may  disappear  spontaneously, 
and  the  treatment  differs  in  no  respect  from  that  of  ordinary  acute 
vaginitis. 

CROUPAL    VAGINITIS. 

Croupal  vaginitis  is  a  form  of  acute  vaginitis,  from  which  it  is  dis- 
tinguished by  the  formation  of  false  membranes  resembling  those  of 
diphtheria  over  the  whole  of  the  vaginal  mucous  membrane. 

It  was  described  by  Baumeister.  Moussu  has  only  seen  one  case, 
and  that  at  a  period  which  rendered  recovery  out  of  the  question. 

Symptoms.  The  external  symptoms  are  those  of  acute  vaginitis, 
with  greyish,  fcetid,  purulent  or  sanguinolent  discharge.  On  examina- 
tion, the  mucous  membrane  is  found  to  be  covered  with  yellowish, 
greyish    false   membranes,   and    with   vegetations  of   a   greyish,   dirty, 

D.C.  N  N 


546  GESUTAL   APPAKATtfS. 

verrucous  appearance.  The  entire  extent  of  the  vaginal  mucous 
memhrane  may  be  attacked,  together  with  the  neck  of  the  uterus.  In 
Moussu's  case  the  uterus  itself  was  entirely  invaded. 

These  false  membranes  and  vegetations  are  very  adherent,  and 
bleed  freely  at  the  slightest  touch.     They  are  apt  to  extend  by  degrees. 

The  cause  of  this  infection  has  not  yet  been  determined.  It  appears 
to  obtain  access  to  the  parts  during  parturition,  and  develops  insidiously 
for  a  week  or  two,  when  widespread  lesions  have  already  formed. 

The  diagnosis  is  extremely  easy. 

The  prognosis  is  grave,  for  the  lesions  have  a  tendency  to  extend 
towards  neighbouring  organs.  Moreover,  the  general  health  is  severely, 
affected  ;  there  is  rapid  wasting,  loss  of  appetite,  and  continued  fever 
and  death  occurs  from  exhaustion,  intoxication,  and  possibly  infection. 

Treatment.  The  treatment  suggested  for  the  ordinary  acute  forms 
appears  to  be  useless  in  this  condition.  The  new  membranes  show 
too  many  folds,  depressions,  and  accidental  culs-de-sac  for  simple  in- 
jections to  have  any  real  effect.  Better  results  might  be  expected 
from  packing  with  antiseptic  gauze  or  from  the  use  of  antiseptic 
ointments  applied  after  washing  out  the  cavity  with  permanganate 
of  potash  solution  or  hydroxyl. 

Curettage,  followed  by  the  use  of  gauze  dressings,  might  also 
be  tried;  considerable  difiticulty  must  necessarily  be  anticipated  in 
operating  in  a  cavity  which  has  become  inextensible  and  partly  filled 
with  vegetations  and  false  membranes. 


CHKONIC    VAGINITIS. 

Chronic  vaginitis  usually  represents  the  last  stage  of  some  form  of 
acute  vaginitis,  though  it  occasionally  develops  in  a  slow  and  progres- 
sive fashion  as  a  primary  condition  in  consequence  of  some  deep-seated 
genital  lesion.    There  is  usually  a  constant  discharge  of  irritant  material. 

The  symptoms  are  not  very  striking,  and  are  purely  local. 

Externally  all  that  can  be  detected  is  a  continuous  or,  much  more 
frequently,  an  intermittent  muco-purulent  discharge  from  the  vulva, 
which  occurs  only  on  urination,  defaecation,  coughing,  etc. 

Locally,  examination  with  a  speculum  discloses  the  fact  that  the 
mucous  membrane  is  of  a  greyish  colour,  thickened,  less  yielding 
than  usual,  and  in  places  sclerosed.  The  entire  thickness  of  the 
mucous  membrane  is  affected,  as  also  at  times  the  muscular  tissue, 
chronic  irritation  having  caused  sclerosis. 

The  diagnosis  is  very  simple,  and  the  prognosis  of  no  particular 
gravity,  because  the  animals  can  always  be  fattened.  The  condition 
is  only  grave  as  regards  animals  intended  for  breeding. 


SEPTIC    METRITIS.  647 

Treatment  is  often  very  successful,  but,  as  in  all  chronic  dis- 
eases, it  extends  over  a  considerable  time.  Practically  it  is  not  often 
attempted.  It  does  not  differ  greatly  from  that  of  ordinary  acute  vagi- 
nitis, but  the  best  results  seem  to  follow  the  use  of  astringents. 

METRITIS. 

Infectious  or  traumatic  diseases  of  the  uterus  are  of  the  greatest 
importance  in  bovine  pa,thology,  both  on  account  of  their  frequency 
and  gravity.  They  comprise  septic  metritis,  acute  metritis,  and  chronic 
metritis. 

SEPTIC    METRITIS. 

Septic  metritis  is  also  termed  "metro-peritonitis"  and  "parturient 
septicaemia."     It  may  be  compared  with  puerperal  fever  in  woman. 

These  terms  are  sufficiently  explicit  to  indicate  that  if  at  first  the 
metritis  is  typical  it  frequently  becomes  complicated  with  peritonitis, 
and  too  often  also  with  true  septiccemia. 

Causation.  The  disease  only  appears  after  parturition  or  abortion, 
and  during  the  few  days  immediately  succeeding  delivery.  Parturition 
may  occur  spontaneously  in  a  perfectly  regular  and  easy  manner,  and 
nevertheless  be  followed  by  fatal  metritis  as  a  consequence  of  infection. 
Usually  the  labour  has  been  difficult,  and  the  after-birth,  or  i^ortions 
of  the  fcetal  membranes,  have  been  retained.  Septic  metritis  then 
develops  in  consequence  of  their  putrefaction. 

Infection  with  micro-organisms  is  therefore  the  essential  cause,  and 
the  only  one  of  importance.  None  of  the  conditions  formerly  invoiced 
can  do  more  than  favour  or  check  the  course  of  this  infection. 

Moreover,  the  subsequent  complications  are  entirely  due  to  the 
special  character  of  the  infective  agent. 

These  infective  agents  may  be  of  various  descriptions.  They  have 
been  the  subject  of  numerous  investigations,  on  account  of  the  gravity 
of  puerperal  fever  in  woman.  Pasteur,  Colin,  Chauveau  and  Doleris 
were  the  first  to  take  up  this  question.  In  veterinary  medicine  several 
inquiries  have  been  instituted,  but  a  great  deal  remains  to  be  done. 
The  most  frequent  agents  are  varieties  of  streptococci,  of  the  colon 
bacillus,  and  of  putrefactive  bacteria. 

Septic  metritis  may  occasionally  be  purely  accidental  and  only 
affect  one  animal,  but  infection  of  stables  by  a  primary  case  is  an 
obvious  cause  of  propagation.  Moussu  has  seen  six  animals  succes- 
sively die  of  septic  metritis  in  one  year,  and  in  a  stable  which  had 
not  been  disinfected  after  each  death. 

Symptoms.  The  first  symptoms  occur  between  the  first  and  fourth 
days   after   parturition,  when    the   uterine   mucous   membrane  is  still 

N  N    2 


548  GENITAL   APPARATUS. 

tender,  discharging  and  bleeding,  and  the  lochial  discharge  is  abun- 
dant. The  disease  rarely  appears  after  the  first  week.  The  earliest 
symptoms  are  dulness,  depression,  loss  of  appetite,  and  general 
weakness.  The  animals  appear  exhausted,  the  secretion  of  milk  is 
diminished  or  altogether  suspended,  and  all  the  chief  functions  of  the 
body  are  interfered  with. 

The  temperature  varies  in  a  peculiar  and  significant  way.  In  some 
forms,  due  to  infection  with  streptococci  or  to  mixed  infection,  it  rises 
to  104°  or  105°  Fahr. ;  in  others  it  remains  stationary  or  falls  below 
normal.  It  might  be  thought  that  in  these  latter  cases,  which  are 
usually  due  to  infection  with  the  colon  bacillus,  the  general  condition 
was  not  grave.  This,  however,  would  be  a  very  serious  error,  for  in 
such  cases  death  follows  as  rapidly  as  in  the  others. 

The  patients,  or  some  of  them  at  least,  have  slight  colic  and 
peritonism  when  the  infection  extends  to  the  peritoneal  pockets  at 
the  entrance  to  the  pelvis.  At  a  later  stage  they  appear  prostrate, 
remain  lying,  and  seem  to  be  suft'ering  from  paralysis  of  the  hind 
quarters. 

None  of  these  general  symptoms  are  in  themselves  significant,  and 
to  appreciate  them  at  their  true  value  the  local  signs  must  be  taken 
into  account. 

The  external  genital  organs  are  moderately  swollen,  the  vagina  is 
infiltrated  and  sensitive,  and  is  soiled  by  exudate  of  varied  character. 

The  neck  of  the  uterus  is  sometimes  prematurely  contracted  after 
the  first  or  second  day,  constituting  a  troublesome  complication  both 
in  examining  the  parts  and  in  treatment.  When,  however,  it  is  dilated 
and  the  hand  can  be  passed,  it  is  found  that  the  uterus  itself  is  not 
contracted  or  is  only  half-contracted,  and  that  it  is  filled  with  a 
reddish-grey  liquid  of  putrid  appearance,  sometimes  without  smell,  at 
others  foetid  or  even  putrid. 

The  uterine  mucous  membrane  is  infiltrated,  thickened,  and  ex- 
tremely fragile,  partially  destroyed,  and  breaks  at  the  slightest  touch. 
The  cotyledons  may  become  loosened  by  necrosis,  and  accumulate  in 
the  depression  formed  by  the  gravid  horn  of  the  uterus  ;  otherwise 
they  may  be  detached  without  difficulty. 

When  the  neck  of  the  uterus  is  prematurely  contracted  direct  ex- 
ploration gives  no  result,  but  rectal  examination  reveals  a  much  en- 
larged uterus,  filled  with  liquid  or  distended  with  putrid  gas. 

If,  however,  the  after-birth  has  not  come  away,  fragments  of  fcetal 
membranes  may  be  removed  from  the  deeper  portions  of  the  uterus 
or  the  surface  of  the  cotyledons. 

Death  is  inevitable  unless  treatment  is  early  initiated.  The  animals 
succumb  to  infection   produced  by  germs  entering  the  vascular  appa- 


SEPTIC    METRITIS.  549 

r-atus.  "When  the  infection  extends  by  contiguity  of  tissue  to  the 
peritoneal  cavity  the  immediate  causes  of  death  are  infection  and  in- 
toxication. In  cases  where  the  infection  remains  localised  within  the 
uterus  the  animal  is  poisoned  by  the  absorption  of  toxins  through  the 
uterine  mucous  membrane. 

The  condition  may  prove  fatal  in  from  four  to  six  days  in  the 
cow,  but  in  a  shorter  period  in  the  goat,  ewe,  and  bitch. 

Lesions.  The  uterus  is  excessively  fragile,  and  can  be  torn  at  will. 
The  mucous  membrane  in  which  the  micro-organisms  more  particu- 
larly develop  appears  necrosed  in  places.  Large  areas  are  sloughing 
or  ulcerated. 

The  vessels  are  thrombosed,  and  extensive  portions  of  the  organ 
may  be  affected  by  true  capillary  phlebitis. 

The  lymphatics  are  dilated  and  distended  with  pus  in  animals 
which  have  resisted  for  some  days. 

If  there  is  peritonitis,  the  entire  floor  of  the  abdominal  cavity  is 
affected,  and  sometimes  the  peritonitis  is  generalised. 

The  lesions  in  the  other  tissues  and  viscera  are  similar  to  those 
found  in  septicemia  and  in  general  intoxication,  such  as  injection 
of  the  capillary  system,  and  interstitial  extravasations  of  blood  in  the 
pleura,  pericardium  and  other  tissues. 

Diagnosis.  The  diagnosis  of  septic  metritis  is  not  very  difficult, 
though  something  more  is  required  than  simple  observation  of  ex- 
ternal signs.  From  the  clinical  standpoint  it  is  of  no  great  import- 
ance to  distinguish  between  the  various  forms  or  to  determine  the 
responsibility  of  micro-organisms  for  the  infection.  In  every  case  the 
practitioner  must  utilise  all  the  means  at  his  disposal. 

Prognosis.  The  prognosis  is  extremely  grave,  and  death  almost 
invariably  occurs  when  treatment  is  not  early  undertaken. 

Treatment.  Treatment  should  be  prompt  and  energetic.  Infection 
of  the  genital  organs  being  the  cause  of  the  symptoms,  it  is  against 
this  that  remedies  should  be  directed.  The  parts  should  first  be 
thoroughly  washed  out  with  boiled  water  at  the  body  temperature. 
A  stiff  drainage  tube  about  6  feet  in  length  is  passed  to  the  base  of 
the  uterus  and  connected  at  its  free  end  with  a  reservoir  of  liquid, 
which  can  be  raised  so  as  to  obtain  sufficient  pressure.  During  this 
operation  the  animals  should  be  placed  with  the  front  limbs  higher 
than  the  hind. 

When  the  liquid  injected  returns  perfectly  clear,  antiseptics  may 
be  employed.  Strong  solutions  containing  mercury,  carbolic  acid, 
lysol  or  creolin  should  be  avoided,  partly  because  of  their  toxic 
action,  but  principally  because  they  cause  irritation  and  violent 
expulsive  efforts. 


550  GENITAL   APPARATUS. 

A  25  per  cent,  hydroxyl  solution  gives  surprisingly  good  results. 
A  1  in  2,000  iodine  solution  (iodine  15  grains,  potassium  iodide 
1  drachm,  warm  water  4  pints)  is  also  of  very  great  service. 

As  the  first  irrigations  are  difficult  to  carry  out  thoroughly,  it  is 
often  advisable  to  cleanse  the  parts  directly  by  means  of  a  large  dis- 
infected sponge,  which  should  be  passed  over  the  whole  surface  of 
the  mucous  membrane  and  into  the  depressions  of  the  uterus,  thus 
directly  removing  septic  liquids.  Thereafter  irrigation  will  be  easier 
and  more  efficacious. 

This  method,  however,  of  cleansing  the  parts  is  dangerous  for  the 
operator  miless  he  takes  the  antiseptic  precautions  necessary  in 
every  case  of  delivery. 

When  the  neck  of  the  uterus  is  prematurely  contracted,  the  diffi- 
culties become  much  greater,  and  are  sometimes  insurmountable  on  ac- 
count of  the  impossibility  of  dilating  it.  It  then  becomes  necessary  to 
use  metallic  canulae  or  uterine  sounds  made  of  aluminium  in  order  to 
pass  through  the  neck  of  the  uterus.  Liquids  can  be  evacuated  by  com- 
pressing the  uterus  through  the  wall  of  the  rectum,  but  the  method 
is  very  troublesome. 

This  local  treatment  should  be  practised  twice  a  day  at  least  until  all 
danger  is  over,  and  may  be  completed  by  the  administration  of  diffusible 
stimulants,  such  as  alcohol  in  doses  of  6  to  10  ounces,  acetate  of 
ammonia  in  doses  of  2  drachms,  wine,  coffee,  and  diuretic  decoctions. 
These  may  be  given  with  food  or  drink  to  whatever  amount  is  con- 
sidered necessary  if  the  animals  still  retain  their  appetite.  The  food 
should  be  light  and  easily   digested. 

From  8  to  12  pints  of  physiological  salt  solution  may  l)e  injected 
intravenously  every  day,  the  temperature  at  which  this  fluid  is  in- 
jected being  varied  according  to  the  degree  of  fever.  (Physiological 
salt  solution  consists  of  chloride  of  sodium  9  parts,  sterilised  water 
1,000  parts.) 

Prophylaxis.  Should  a  case  of  septic  metritis  occur  in  a  byre  con- 
taining  other  cows  about  to  calve  the  building  should  be  disinfected. 


ACUTE    METRITIS. 

The  term  "  acute  metritis  "  is  used  to  indicate  a  variety  of  inflam- 
mation of  the  uterus  of  a  sufficiently  grave  character,  which,  however, 
does  not  prove  fatal  in  twenty-four  or  forty-eight  hours. 

Causation.  In  domestic  animals  acute  metritis  develops  exclusively 
after  difficult  parturition  and  as  a  consequence  of  the  tearing  of  tissues 
or  accidental  post-par tum  infection. 

At  one  time  it  was  the  rule  to  recognise  a  traumatic  form  consequent 


ACUTE    METRITIS.  551 

on  wounds  by  embryotomy  hooks,  crutches,  cords,  etc.,  etc.  There  is 
no  reason  for  maintainmg  this  distinction,  because  the  essential  condi^ 
tion  for  the   development   of   metritis   is  the  infection  of  the  injuries. 

Acute  metritis  follows  non-delivery,  incomplete  delivery,  or  acci- 
dental infection. 

Symptoms.  The  external  signs  are  very  few,  and  must  be  carefully 
studied,  in  order  that  wrong  conclusons  may  be  avoided. 

Certain  of  these  external  signs  suggest  general  disturbance  such  as 
one  finds  in  all  acute  visceral  inflammations,  viz.,  loss  of  appetite,  prO' 
gressive  wasting,  irregular  slight  fever,  diminution  or  cessation  of  the 
secretion    of   milk,   dulness,  etc. 

The  others  are  purely  local.  The  discharge  from  the  vagina  is 
mucoid,  muco-puralent,  sanguinolent  or  fcetid,  according  to  circum- 
stances.  It  is  small  in  quantity,  and  occurs  only  when  the  animal 
lies  down  or  makes  expulsive  efforts.  Examination  with  the  specu- 
lum reveals  the  existence  of  slight  secondary  vaginitis  and  more 
intense  inflammation  of  the  neck  of  the  uterus,  which  remains  half 
open.  Rectal  examination  shows  that  the  uterus  is  abnormally  large 
and  more  difficult  than  usual  to  displace.  If  acute  metritis  has 
existed  for  some  weeks,  the  uterus  is  painful  to  the  touch,  and  some- 
times fixed  in  position  in  consequence  of  the  development  of  para- 
metritis and  of  slight  pelvi-peritonitis,  the  occurrence  of  which  is 
always  indicated  by  temporary  tympanites. 

Cases  of  acute  metritis  may  recover  spontaneously,  but  they  rarely  do 
so.  The  condition  usually  tends  to  become  chronic  or  to  be  complicated 
with  peri-uterine  diseases  which  may  prove  fatal. 

Diagnosis.  The  diagnosis  can  be  established  without  difficulty  by 
rectal  examination  and  direct  examination  with  a  speculum. 

Prognosis.  The  prognosis  is  grave,  because  the  patients  are  tem- 
porarily or  permanently  incapable  of  becoming  pregnant,  and  because 
acute  metritis  may  be  complicated  with  pelvi-peritonitis,  phlebitis  of 
the   intra-pelvic   veins,   etc. 

Treatment.  The  uterus,  and  particularly  the  uterine  mucous  mem- 
brane, being  affected,  all  our  efforts  should  be  concentrated  on  that  organ. 
A  careful  study  of  the  lesions  shows  that  the  glandular  follicles  are 
infected,  and  with  them  the  entire  thickness  of  the  mucous  membrane. 
The  object  to  be  attained,  therefore,  is  the  perfect  disinfection  of  this 
tissue.  The  parts  should  repeatedly  be  washed  out  with  warm  water  at 
blood-heat,  followed  by  antiseptic  injections  containing  4  drachms  of 
chloral  per  pint ;  a  1  in  2,000  iodine  solution  or  20  per  cent,  to  25  per 
cent,  hydroxyl  solution,  etc.  Despite  such  injections,  the  inflamma- 
tion disappears  slowly  and  with  difficulty,  and  when  the  neck  is  suffi- 
ciently open    it   might   perhaps   be   possible,    as   in   human    medicine. 


552  GENITAL   APPARATUS. 

slightly  to  curette  the  mucous  membrane  of  tlie  uterus  and  plug  the 
cavity  with  iodoform  gauze. 

Where,  however,  the  neck  of  the  uterus  is  so  far  contracted  as  no 
longer  to  admit  a  sound  or  canula  for  irrigation,  the  difficulties  are  very 
great.  Nothing  effectual  can  be  done  until  the  neck  of  the  uterus  is 
dilated,  an  exceedingly  troublesome  operation. 

In  the  forms  termed  "  post-partum  traumatic  metritis "  antiseptic 
injections  must  not  be  made  with  any  considerable  pressure,  because 
of  the  danger  of  rupture ;  plugging  the  cavity  with  antiseptic  gauze  is 
preferable. 

CHKONIC    METRITIS. 

Chronic  metritis  is  often  the  termination  of  acute  metritis,  though  in- 
flammation of  the  uterine  mucous  membrane  may  assume  the  chronic 
form  from  the  first.  All  post-partum  infections  with  pathogenic  microbes 
may  give  rise  to  chronic  metritis,  as  may  the  various  forms  of  cystitis, 
vaginitis,  rupture  of  the  vulva,  etc.  Tuberculosis  also  leads  to  chronic 
metritis,  which  is  easily  diagnosed  by  a  simple  bacteriogical  examination 
of  the  discharge. 

Symptoms.  Chronic  metritis  is  accompanied  by  bad  general  health 
and  persistent  local  disturbance.  The  animals  show  a  permanent  muco- 
purulent discharge  varying  in -amount,  or  simply  an  intermittent  dis- 
charge, which  is  then  more  abundant  and  only  lasts  some  hours  or 
some  days,  but  reappears  after  irregular  intervals.  On  examination  the 
neck  of  the  uterus  is  found  to  be  half  open,  slightly  hypertrophied, 
sometimes  sensitive,  and  covered  with  vegetations. 

Examination  through  the  rectum  may  show  the  organ  to  be  con- 
siderably hypertrophied,  sensitive,  and  comparatively  immobile.  Cases 
are  numerous,  however,  in  which  the  examination  reveals  nothing 
very  striking. 

In  other  cases,  vaginal  examination  by  means  of  the  speculum  reveals 
nothing,  except  that  the  neck  of  the  uterus  is  completely  closed,  and  yet 
on  rectal  examination  the  uterus  is  found  to  be  of  large  size,  tense,  uni- 
formly fluctuating,  and  in  exactly  the  position  to  be  expected  were  the 
animal  pregnant.  This  clinical  form  was  formerly  termed  "  hydro- 
metritis,"  but  it  would  be  better  named  "  pyo-metritis,"  inasmuch  as  it 
depends  on  chronic  metritis.  The  neck  of  the  uterus  remains  con- 
tracted, and  the  morbid  products  accumulate  in  the  body  and  uterine 
horns,  which  are  gradually  dilated.  Then  suddenly  the  uterus  is 
seized  with  reflex  contractions  overcoming  the  resistance  of  the  neck 
and  expelling  the  contents  in  one  jet.  The  discharge  may  continue 
for  some  days,  after  which  the  neck  again  closes  and  the  disease 
enters  on  a  new  phase. 

Lesions.     The  lesions  affect  the  mucous  membrane,  more  particularly 


EPIZOOTIC    ABORTION    IN    COWS.  553 

the  glandular  tissue  and  the  interstitial  tissue.  From  the  anatomical 
and  pathological  point  of  view  different  forms  are  recognised,  some  with 
glandular  and  mucous  atrophy,  others  with  marked  hypertrophy,  the 
mucous  membrane  being  covered  in  some  cases  with  vegetations  and 
fungus-like  growths. 

Diagnosis.  From  a  clinical  standpoint,  it  is  only  necessary  to  dis- 
tinguish the  ordinary  forms  from  tuberculous  metritis,  which  latter  is 
of  no  clinical  importance  on  account  of  the  impossibility  of  treatment. 

Prognosis.  The  prognosis  is  grave,  as  in  all  chronic  diseases. 
Furthermore  the  animals  are,  for  the  time  being,  sterile  and  diffi- 
cult to  fatten. 

Treatment.  One  of  the  fundamental  conditions  of  treatment  is  to 
attack  the  disease  locally,  and  it  is  necessary,  therefore,  that  the 
uterine  neck  should  be  dilated. 

If  the  neck  of  the  uterus  is  pervious,  the  parts  must  be  washed 
out  daily  with  antiseptic  solutions,  after  having  lightly  curetted  the 
mucous  membrane  with  a  blunt  curette.  Boiled  water  is  first  used, 
and  is  followed  by  solutions  of  chloral,  iodine,  hydroxyl,  or  per- 
manganate of  potash. 

When  the  neck  of  the  uterus  is  contracted,  it  must  first  of  all  be 
dilated.  In  practice  such  treatment  is  sometimes  considered  too  costly, 
so  that  the  animals  are  slaughtered  or  recovery  is  left  to  chance. 

Moussu  has  seen  several  animals  suffering  from  metritis,  and  even 
from  salpingitis,  recover  spontaneously  after  six  to  eight  months  at  grass. 

EPIZOOTIC    ABORTION    IN    COWS. 

This  disease,  which  was  carefully  investigated,  first  by  Professor 
Nocard  of  Alfort,  and  afterwards  by  Professor  Bang  of  Copenhagen,  may 
be  regarded  as  a  specific  uterine  catarrh,  determined  by  a  definite 
species  of  bacterium. 

It  often  affects  large  numbers  of  animals  in  one  district  or  on 
one  farm,  and  causes  very  serious  loss.  It  is  conveyed  from  cow  to 
cow  either  by  the  bull  or  by  litter  or  utensils  used  in  the  byre  which 
have  been  soiled  by  the  uterine  discharges  of  an  infected  cow.  As 
in  many  other  infectious  disorders,  one  attack  of  the  disease  seems 
to  confer  a  certain  immunity,  and  although  some  cows  become  sterile 
after  an  attack  and  others  continue  to  abort,  a  certain  proportion 
after  aborting  two  or  three  times  acquire  relative  immunity,  so  that 
they  conceive  and  carry  their  calves  the  full  time.  This  is  probably 
why  epizootic  abortion  usually  ceases  after  some  years  in  herds  which 
are  kept  isolated  and  do  not  receive  fresh  recruits. 

The  microbe  of  epizootic  abortion  is  a  very  small  bacterium  which 
stains   well   with   Loffler's    methylene    blue.     When    massed    together 


554  GENITAL   APPARATTTS. 

these  bacteria  resemble  cocci,  ))ut  isolated  specimens  are  seen  to  be 
true  bacteria  containing  one,  two,  or  occasionally  three  roundish, 
elongated  deeply-stained  granules.  They  do  not  stain  with  Gram, 
and  are  non-motile. 

These  bacteria  exhibit  remarkable  vitality.  Bang  relates  cases 
which  seem  to  prove  that  they  may  exist  within  the  uterus  for  at 
least  fourteen  months,  and  in  the  uterine  exudate  outside  the  body 
for  at  least  seven  months,  even  at  comparatively  low  temperatures. 

On  post-mortem  examination  one  finds  between  the  mucous  mem- 
brane of  the  uterus  and  the  foetal  envelopes  an  abundant  odourless 
exudate,  dirty-yellow  in  colour,  somewhat  thin,  pultaceous,  slimy,  or 
lumpy  in  character.  Under  the  chorion  is  found  a  thin,  clear,  gela- 
tinous substance  contained  within  the  fine  connective  tissue  lying 
between  the  chorion  and  allantois.  The  umbilical  cord  is  often  axle- 
matous.     All  these  exudates  contain  the  specific  minute  bacterium. 

The  above  exudate  forms  the  peculiar  dirty,  reddish-yellow,  slimy, 
flocculent,  pus-like  odourless  fluid  which  escapes  from  the  vagina 
during  or  immediately  after  the  act  of  abortion. 

The  results  of  infection  of  the  uterus  with  Bang's  bacterium 
may  be  delayed  for  a  considerable  time.  In  two  cases  where  he 
injected  pure  cultures  into  the  vaginte  of  pregnant  cows  no  apparent 
local  results  had  been  produced  at  the  end  of  thirty-three  and  thirty- 
five  days  respectively  when  the  cows  were  slaughtered ;  but  in  the 
case  of  two  other  pregnant  cows,  inoculated  three  months  after  con- 
ception, signs  of  abortion  became  ajDparent,  and  one  cow  in  fact 
aborted  in  about  ten  weeks ;  post-mortem  examination  revealed  the 
characteristic  local  changes,  and  microscopical  and  cultural  prepara- 
tions clearly  established  the  presence  of  the  specific  organism. 

Although  the  sexual  organs  form  the  usual  channel  of  infection, 
it  seems  possible  that  the  organism  may  in  some  cases  enter  the 
body  through  the  respiratory  or  digestive  tract. 

The  treatment  in  this  condition  is  chiefly  of  a  prophylactic 
character.  Bulls  which  have  served  cows  belonging  to  herds  known 
to  be  infected  should  not  be  allowed  to  cover  healthy  cows.  They 
should  undergo  careful  local  disinfection,  and  for  a  time  be  with- 
drawn from  the  stud. 

Cows  which  show  signs  of  impending  abortion  should  at  once  be 
removed  to  a  separate  shed.  The  fcetus  and  its  envelopes  should 
be  buried  or  burnt,  and  the  person  who  attends  the  diseased  cow 
should  be  prohibited  from  entering  the  common  cow-shed. 

Where  space  does  not  admit  of  this  the  -affected  cows  should  be 
removed  as  far  as  possible  from  those  still  healthy  and  j)laced  in  a 
separate   row.     When   they   abort   the   ^fter-birth  should   b^  removed 


SALPINGITIS — SALPINGO-OVARITIS.  555 

l)y  hand,  and  the  uterus  daily  washed  out  with  some  non-irritant 
but  effectual  disinfectant.  Even  after  apparent  recovery  a  period  of 
probation  should  elapse  before  the  cow  is  again  put  to  the  bull. 

The  genital  organs  and  vaginae  of  the  still  healthy  animals  may 
also  be  irrigated  with  a  disinfectant  solution,  in  order,  if  possible,  to 
ward  off  infection.  For  disinfecting  the  channels  and  floor  of  the 
stable  quick-lime  will  be  found  clean,  non-odorous,  cheap  and  effective. 

In  dealing  with  this  disease  one  must  always  bear  in  mind  the 
great  vitality  of  the  bacterium,  the  relatively  long  time  it  may  per- 
sist either  in  the  animal's  body  or  in  the  infected  sheds,  and  the 
considerable  period  which  may  elapse  before  its  effects  become  evident. 

The  same  or  a  similar  organism  seems  capable  of  producing 
abortion  in  sheep  and  mares. 

SALPINGITIS-SALPINGO'OVARITIS. 

This  section  will  be  brief,  because  the  condition  is  very  far  from 
having  been  thoroughly  elucidated.  Moussu  himself  has  only  studied 
a  single  case  of  simple  suppurative  salpingo-ovaritis. 

Salpingitis  and  salpingo-ovaritis,  i.e.,  inflammation  of  the  Fallo- 
pian tubes  and  of  the  ovaries,  can  only  develop  as  a  consequence  of 
ascending  infection,  as  a  complication  of  acute  or  chronic  metritis, 
by  auto-infection  during  the  course  of  tuberculosis,  or  as  an  accident 
during  what  is  known  as  tubal  gestation. 

Tuberculous  salpingitis  is  frequent,  and  exists  in  a  very  large 
majority  of  cases  of  genital  tuberculosis.  Accidental  salpingitis  as  a 
consequence  of  tubal  gestation  is  extremely  rare,  and  is  usually  over- 
looked or  mistaken  for  some  other  condition. 

From  the  clinical  standpoint,  therefore,  we  recognise  two  varieties 
of  salpingitis — the  one  suppurative,  the  other  tuberculous. 

Symptoms.  The  external  symptoms  are  similar  to  those  of 
metritis,  because  salpingitis  develops  as  a  complication  of  metritis 
after  parturition,  abortion,  or  retention  of  the  after-birth.  The  only 
external  symptom  is  a  discharge  of  varying  quantity  from  the  vulva. 
This  may  be  intermittent  or  permanent,  and  it  is  accompanied  by 
frequent  expulsive  efforts  in  no  respect  characteristic. 

The  nature  of  the  lesions  is  ascertained  by  rectal  examination,  and 
as  lesions  of  the  uterus,  of  the  Fallopian  tube,  and  sometimes  of 
the  ovary  often  co-exist,  the  examination  must  be  carried  out  me- 
thodically and  gently  in  order  to  distinguish  between  the  parts 
touched.  The  normal  relationships  may  be  modified  by  uterine 
lesions,  inflammatory  adhesions,  local  peritonitis,  etc. 

Diagnosis.     The  diagnosis  requires  care. 


553  OENITAL   APPAHATUS. 

Prognosis.  The  prognosis  is  grave.  The  lesions  are  too  deep- 
seated  to  he  directly  attacked,  and,  moreover,  salpingitis  may  termi- 
nate in  })yo-salpyiix,  i.e.,  in  encysted  ahscess  of  the  Fallopian  tube. 

Treatment.  The  treatment  is  similar  to  that  of  metritis.  The 
natm-al  opening  of  the  Fallopian  tube  into  the  uterus  allows  pus 
and  morbid  products  to  escape,  and  when  the  metritis  disappears 
the  salpingitis  may  diminish  and  recovery  may  take  place. 

Treatment  therefore  is  quite  indirect,  for  in  veterinary  surgery  it 
is  useless  to  attempt  to  repeat  on  large  domestic  animals  the  brilliant 
operations  of  human  surgery.  The  relations  between  uterine  diseases 
and  those  of  the  Fallopian  tubes  are  so  close  that  this  method  of 
treatment  gives  excellent  results.  Moussu  has  seen  a  case  of  chronic 
metritis  complicated  with  salpingitis  recover  after  simple  uterine  treat- 
ment. 

TORSION    OF    THE    UTERUS. 

Although  torsion  of  the  uterus  is  a  condition  more  particularly 
pertaining  to  the  domain  of  obstetrics,  a  few  remarks  on  the  subject 
may  not  be  altogether  out  of  place  at  this  point. 

The  accident  is  commonest  in  the  cow,  Init  it  has  also  l)een  described 
in  the  mare,  ewe,  bitch  and  cat,  and  it  probably  occurs,  though  less 
frequently,  in  the  other  domestic  animals.  In  the  cow  it  is  com- 
monest during  the  last  month  of  pregnancy. 

Very  little  is  known  as  to  its  cause,  though  the  consensus  of  opinion 
— if  any  consensus  can  be  said  to  exist  in  face  of  the  existing  diver- 
gent views — appears  rather  to  indicate  that  it  follows  falls  in  awkward 
positions,  sudden  efforts,  severe  prolonged  exertion,  or  tympanites. 

In  pregnant  cows  the  uterus  assumes  the  appearance  of  a  pen- 
dulous organ  the  l)ody  and  horns  of  which  constitute  the  bob  of  the 
pendulum,  whilst  the  ligaments  represent  the  cords  by  which  it  is 
suspended.  The  fixed  points  are  formed  by  the  insertions  of  the  two 
ligaments  in  the  neighbourhood  of  the  two  external  iliac  angles. 

The  uterus,  however,  is  also  steadied  in  position  by  the  vagina 
and  by  the  cellular  tissue  surrounding  it ;  in  fact,  in  non-pregnant 
animals  it  can  scarcely  be  regarded  as  pendulous,  but  rather  as  freely 
floating  and  readily  yielding  to  the  movements  of  the  surrounding- 
organs. 

As  soon  as  the  uterus  is  occupied  by  a  fcetus,  however,  the  con- 
ditions become  changed.  In  consequence  of  the  increased  weight  of 
its  contents  the  uterus  exerts  a  pull  on  the  broad  ligaments  and 
sinks  lower  in  the  abdominal  cavity.  The  vagina  and  the  surround- 
ing connective  tissue  are  rendered  tense  to  a  degree  depending  on  the 
increasing  weight  of  the  calf.     The  uterus  then  more  closely  resembles 


TORSION   OF   THE   UTERUS.  557 

a  pendulum,  the  bob  being  represented  by  the  fcetus  and  its  envelopes. 
The  suspensory  apparatus  can  be  divided  into  three  parts,  viz.,  the 
two  broad  ligaments  and  the  tissue  connecting  the  uterus  to  the 
vagina. 

The  pull  on  the  vagina  increases  greatly  as  soon  as  the  gravid 
uterus  is  twisted  either  to  the  right  or  left,  for,  torsion  being  attended 
with  more  or  less  extensive  displacement  towards  the  lower  abdominal 
wall,  the  tension  on  the  vagina  must  become  more  marked. 

Considering  now  how  the  sjiiral  folds  and  the  constrictions  which 
are  of  such  importance  in  diagnosis  are  formed,  we  find  that  both 
structures,  viz.,  the  wall  of  the  uterus  and  the  ligaments,  are  impli- 
cated, though  to  dilierent  degrees.  Whilst  the  spiral  folds  are  more 
particularly  formed  by  the  wall  of  the  uterus,  the  broad  ligaments  are 
chiefly  responsible  for  the  constrictions,  though  to  some  extent  the 
spiral  folds  also  contribute  to  their  production.  The  spiral  folds  of 
the  body  of  the  uterus  are  formed  solely  by  twisting  of  its  own  walls. 
This  can  easily  be  shown  by  taking  any  tubular  organ  whose  walls 
are  not  too  rigid,   and  twisting  it  round  its  horizontal  axis. 

The  broad  ligaments  contribute  less  to  the  formation  of  the  spiral 
folds,  though  they  play  a  more  important  part  in  producing  con- 
strictions and  thus  in  compressing  the  wall  of  the  uterus. 

The  symptoms  are  ill-defined.  Sometimes  there  is  difficulty  in 
micturition,  but  as  a  rule  little  evidence  exists  of  any  abnormal  con- 
dition until  the  advent  of  labour  pains.  The  first  pains,  which  are 
usually  feeble  and  separated  by  rather  long  intervals,  are  succeeded 
by  colic.  The  succeeding  efforts  steadily  become  more  violent  and 
frequent,  but  the  "water-bag"  fails  to  appear,  and  in  a  period  varying 
between  twelve  and  forty-eight  hours  the  pains  subside.  Kumination 
is  at  first  suspended,  the  pulse  and  respiration  are  accelerated,  and 
the  surface  temperature  is  irregular. 

If  treatment  is  not  undertaken  similar  symptoms,  but  of  exaggerated 
intensity,  may  again  appear  in  from  one  to  six  days.  Failing  relief 
death  always  follows  after  a  varying  interval. 

The  diagnosis  is  not  difficult,  provided  the  maternal  passages  be 
examined.  On  passing  a  carefully  lubricated  hand  into  the  vagina  the 
operator  discovers,  at  a  varying  distance,  from  the  os  uteri,  signs  of 
collapse  and  twisting  of  the  canal.  In  cases  of  quarter  twist  it  is 
often  possible,  by  rotating  the  hand  so  as  to  follow  the  spiral  folding 
of  the  vagina,  to  introduce  the  fingers  as  far  as  the  os  uteri ;  but  in 
half  or  complete  rotation  only  one  or  two  fingers  can  be  passed  so 
far,  or  it  may  be  altogether  impossible  to  reach  the  os. 

In  the  Berliner  Archiv  for  1902  Lempen  gave  a  summary  of  the 
extensive  literature  dealing  with  this  disease  and  of  the  varying  views 


558  GENITAL   APPARATUS. 

held  regarding  its  origin  and  treatment,  particularly  as  to  the  direction 
in  which  the  animal  should  be  rolled  in  order  to  reduce  the  torsion. 

In  common  with  the  majority  of  authors,  Lempen  rightly  con- 
cluded that  the  rolling  should  be  in  the  same  direction  as  the  torsion. 
He  also  proposed  to  describe  the  torsion  as  being  to  right  or  left, 
according  to  the  direction  of  the  spiral  folds  to  be  found  on  the  upper 
wall  of  the  dilated  cervix  uteri  when  the  examiner  stands  behind  the 
animal.  This  mode  of  describing  the  changes  seems  least  likely  to 
cause  misunderstanding. 

In  describing  the  degree  of  torsion  Haase  takes  as  his  index  the  upper 
wall  of  the  uterus.  Where  this  has  moved  through  an  angle  of  90  degrees 
he  speaks  of  quarter  torsion ;  when  through  an  angle  of  180  degrees  (in 
which  case  the  upper  wall  will  have  become  the  lower)  of  half  or  semi-com- 
plete torsion  ;  when  through  an  angle  of  270  degrees  as  three-quarter, 
and  when  through  360  degrees  (the  upper  wall  having  then  described 
an  entire  circle  and  returned  to  its  former  position)  as  comj^lete  torsion. 

In  forming  a  diagnosis,  the  extent  to  which  the  maternal  passages 
seem  fixed  in  position,  the  amount  of  resistance  they  offer  to  the  hand, 
and  the  degree  of  tension  in  the  spiral  folds  to  some  extent  indicate 
how  far  torsion  has  proceeded.  Where  the  spiral  folds  are  very  tense 
and  the  passages  completely  immovable,  so  that  the  operator  cannot 
reach  the  foetus,  torsion  is  usually  complete ;  in  cases  of  less  complete 
torsion  (one-quarter  to  three-quarters)  the  cervix  uteri  is  closed  and 
displaced  to  a  proportionate  extent,  and  the  resistance  to  the  passage 
of  the  hand  is  in  keeping. 

The  prognosis  is  very  grave. 

Treatment  is  difficult,  and  of  the  numerous  methods  suggested 
(laparotomy  and  direct  abdominal  taxis,  vaginal  hysterotomy  followed 
by  abdominal  taxis,  vaginal  taxis,  etc.)  most  have  fallen  into  desue- 
tude or  are  looked  on  as  of  so  desperate  a  character  as  only  to  be 
justified  in  extreme  cases.  That  which  most  merits  attention  and 
has  been  attended  by  most  uniformly  favourable  results  consists  in 
the  rotation  of  the  animal's  whole  body.  The  best  results  are  said  to 
be  obtained  by  casting  the  animal,  or  causing  it  to  lie  down,  on  a 
sloping  surface  with  the  hind  quarters  higher  than  the  fore  and  then 
to  roll  it  down  hill,  in  the  same  direction  as  the  spiral  twists  discovered 
in  the  vagina.  It  is  possible  to  follow  the  course  of  the  manipulation 
by  retaining  the  hand  in  the  vagina,  but  failing  this  the  vagina  should 
be  examined  after  each  attempt.  Even  though  the  first  attempts  fail 
hope  should  not  be  abandoned,  for  Haase  has  succeeded  in  effecting 
delivery  after  rolling  the  animal  twenty  times.  The  operation  should 
be  performed  smartly  and  the  animal's  body  be  rolled  as  a  whole, 
the  fore  limbs  turninj^  along  with  the  hind. 


TUMOURS   OF   THE   OVAllY.  559 


TUMOURS    OF    THE    UTERUS. 


The  study  of  tumours  of  the  uterus  is  still  so  incomplete  that  it 
would  be  impossible  to  give  a  precise  description  of  them.  This  is 
to  a  great  extent  due  to  the  fact  that  as  treatment  is  difficult  the 
animals  are  usually  slaughtered  as  soon  as  an  assured  diagnosis  can 
be  given. 

The  general  symptoms  of  tumours  of  the  neck,  body,  or  horns  of 
the  uterus  resemble  those  of  chronic  metritis,  viz.,  permanent  or  inter- 
mittent discharge  from  the  vulva,  wasting,  expulsive  efforts,  dysuria 
and  sterility.  The  position  of  the  tumour,  its  form,  point  of  insertion, 
size,  consistency,  mode  of  attachment,  etc.,  can  be  detected  by  vaginal 
or  rectal  examination. 

The  diagnosis  having  been  made,  the  only  question  is  as  to  treat- 
ment. Should  the  tumour  prove  mobile,  clearly  delimited,  and  with 
a  well-marked  pedicle,  it  can  be  removed  either  by  tearing  away  or 
by  breaking  into  fragments,  or  again  simply  by  dividing  the  pedicle 
and  applying  antiseptic  pads  to  check  bleeding.  But  if  the  tumour 
proves  largely  sessile  and  ill-delined  and  it  extends  into  neighbouring 
tissues  the  animal  should  be  slaughtered,  as  such  patients  can  neither 
be  fattened  nor  used  for  reproductive  purposes. 

TUMOURS    OF.  THE    OVARY. 

We  might  repeat  in  regard  to  tumours  of  the  ovary  what  has 
just  been  said  as  regards  those  of  the  uterus,  though  the  former 
are  much  commoner  than  the  latter. 

Clinically,  ovarian  tumours  may  be  grouped  under  two  heads,  solid 
tumours  and  cystic  tumours — the  first  represented  by  the  fibromata, 
fibro-sarcomata  and  epitheliomata,  the  second  by  uni-  or  multi-  locular 
cysts. 

All  these  tumours  are  dangerous ;  they  may  develop  rapidly,  and 
they  rarely  fail  to  produce  disturbance,  the  animals  presenting  various 
genital  troubles,  among  which  may  be  mentioned  sterility  and  nympho- 
mania. 

The  cystic  tumours,  which  develop  at  the  expense  of  epithelial 
invaginations  of  the  peritoneal  covering  or  at  the  expense  of  Pfliiger's 
tubes,  and  not,  as  was  formerly  believed,  by  the  morbid  development 
of  the  Graafian  vesicles,  constitute  dangerous  growths,  true  cysto- 
epitheliomata  or  cystic  epitheliomata,  capable  of  producing  fatal 
complications  (vascular  disturbance,  local  or  general  peritonitis,  com- 
pression of  the  ureters,  etc.). 

The  diagnosis  must  be  arrived  at  by  vaginal  and  rectal  examination. 


560  GENITAL    APPARATUS. 

It  is  usuiilly  possible  to  distinguish  the  condition  from  disease  of  the 
kidney,  l)liulder,  or  pelvic  lymphatic  glands. 

Treatment,  'i'he  only  possible  treatment  is  removal  of  the  dis- 
eased ovary  and  of  the  ovarian  tumour,  but  much  depends  on  circum- 
stances. If  a  large  tumour  has  formed  extensive  adhesions,  ablation 
may  be  impracticable  or  so  dangerous  that  under  the  circumstances 
in  which  veterinary  practitioners  are  forced  to  operate  it  cannot  be 
undertaken.  If,  on  the  contrary,  the  ovarian  growth  is  free  and 
pedunculated,  even  though  of  large  size,  extirpation  is  possible. 

The  method  is  exactly  similar  to  that  of  castration  of  the  cow, 
and  follows  the  same  rules,  but  the  vaginal  incision  has  to  be  much 
longer,  so  as  to  allow  the  entire  hand  to  be  passed  as  far  as  the 
tumour.  The  pedicle  is  divided  by  means  of  the  ecrascur,  which 
should  1)6  worked  very  slowly.  In  removing  very  large  tumours, 
however,  it  is  possible  to  operate  from  the  flank. 

GENITAL    MALFORMATIONS. 

IMPERFORATE    VAGINA. 

Many  forms  of  genital  malformation  occur,  but  only  those  which 
produce  sterility  are  pathologically  important. 

One  alone  causes  very  marked  disturbance,  viz.,  imperforate  vagina. 
This  condition  may  be  accidental  or  acquired,  and  may  follow  either 
difficult  parturition,  with  circular  lesions  of  the  vagina,  or  burns  or 
cauterisation  of  the  vagina,  followed  by  adhesion  of  its  walls. 

It  is  generally  of  congenital  origin,  and  the  obstruction  as  a 
rule  is  in  the  region  of  the  hymen,  as  a  consequence  of  some 
anomaly  in  development,  and  not  of  abnormal  development  of  the 
hymen  itself. 

This  imperforate  condition  of  the  vagina  is  not  attended  by  grave 
consequences  during  early  life;  but  later,  when  the  generative  func- 
tions become  active,  all  the  products  of  secretion  of  the  uterine  and 
vaginal  mucous  membranes  accumulate  in  the  closed  cavity,  giving 
rise  first  to  muco-metritis,  then  to  muco-kolpitis,  similar  in  its  develop- 
ment to  the  hfemato-kolpitis  of  young  girls.  The  uterus  gradually 
becomes  distended  with  liquid,  the  neck  is  dilated,  and  a  portion  of 
the  vagina  may  attain  enormous  dimensions,  so  much  so  as  to  suggest 
pregnancy. 

Symptoms.  The  symptoms  become  appreciable  only  after  a  time 
about  one  year  or  fifteen  months  in  heifers — and  they  seem  to  be  asso- 
ciated with  the  appearance  of  oestrum.  The  animals  make  continued 
expulsive  efforts,  which  when  the  genital  canal  is  much  distended  may 
become  extremely  violent.     There  is  also  dysuria  as  a  consequence  of 


IMPEUFORA.TE   VAGINA. 


561 


compression,  together  ^Yith  uterine  and  vesical  colic,  loss  of  appetite 
and  wasting. 

Diagnosis.  The  diagnosis  requires  care,  and  can  only  he  arrived 
at  after  examination  of  the  vagina  and  examination  per  rectum.  In 
young  females  this  examination  is  extremely  difficult,  because  of  the 
narrowness  of  the  genital  tract  and  of  the  rectum.  For  vaginal  exami- 
nation w^e  prefer  to  use  a  small  speculum,  which  exposes  the  depths  of 
the  vagina  or  the  transverse  septum  without  necessitating  other 
manipulation.      On   rectal   examination    the    uterus    and    vagina    are 


Fig.  235. — Imperforate  vagina :  position  and  appearance  of  the  genital  organs.  Cu 
Distended  uterine  horns  (muco-metritis) ;  Ya,  dilated  extremity  of  the  vagina ; 
Ye,  bladder,  distended  with  urine,  owing  to  compression  of  the  urethra.  The  hymen 
was  situated  about  1^  to  1^  inches  in  front  of  the  meatus  urinarius. 


sometimes  found  to  he  enormously  enlarged,  and  to  contain  a  quantity 
of  fluid,  but  no  foetus. 

Prognosis.  The  prognosis  is  grave.  Unless  treatment  is  under- 
taken the  animals  die  in  consequence  of  exhaustion  or  secondary 
peritonitis. 

The  treatment  is  simple,  and  consists  in  aseptic  puncture  of  the 
septum  and  evacuation  of  the  contents.  The  operation  is  carried  out 
with  a  long,  large-sized  trocar,  which  is  passed  through  the  centre  of 
the  most  prominent  portion  of  the  transverse  septum  where  it  projects 
towards  the  vulva.  Five,  ten,  or  fifteen  quarts  of  mucous  fluid  escape, 
and  the  constitutional  disturbance  disappears  almost  instantly. 

D.C  O  O 


562  GENITAL    APPARATUS. 

Antiseptic  precautions  are  necessar}^  in  order  to  avoid  the  develop- 
ment of  secondary  pj'o-metritis.  The  artificial  orifice  can  afterwards  be 
gradually  dilated  to  allow  free  exit  to  the  discharges,  but  in  practice,  as 
the  animals  cannot  be  used  for  breeding  purposes,  they  are  usually 
fattened  for  slaughter. 

NYMPHO'MANIA. 

The  term  "  nympho-mania  "  is  employed  to  describe  a  special  con- 
dition in  female  animals  which  is  manifested  by  continual  sexual 
excitement.  The  animals  are  almost  always  sterile.  The  disease  is 
most  frequent  in  cows. 

Causation.  This  general  condition  may  depend  on  one  of  many 
causes,  but  is  rarely  due  to  a  true  neurosis,  as  was  once  believed. 
Some  morbid  influence  of  genital  origin  is  always  responsible  for  the 
appearance  of  the  symptoms. 

Nympho-mania,  therefore,  often  co-exists  with  lesions  of  the  ovaries 
(simple  ovaritis,  cystic  ovaritis,  tumours  of  the  ovary),  with  lesions  of 
the  Fallopian  tubes  and  of  the  uterus  (salpingitis,  chronic  metritis 
and  tumours  of  the  uterus),  with  chronic  vaginitis  and  lesions  of  the 
clitoris  (hypertrophy  and  tumour  formation),  and  even  with  peri- 
vaginal or  peri-uterine  lesions  (cysts  or  tumours). 

In  exceptional  cases  it  may  be  found  occurring  as  a  simple  nervous 
disturbance  without  genital  lesion,  and  it  would  then  appear  to  be  due 
to  some  temporary  genital  affection  having  produced  nervous  irritation. 

In  short,  nympho-mania  may  be  considered  as  almost  invariably  the 
result  of  a  genital  lesion. 

Symptoms.  The  symptoms  are  very  clearly  marked.  They  consist 
in  persistence  of  the  sexual  appetite,  which  is  quite  abnormal  in  female 
domestic  animals.  The  patients  lose  flesh,  feed  badly  and  irregu- 
larly, annoy  their  fellows,  cause  accidents,  and  sometimes  become 
dangerous. 

Diagnosis.  The  diagnosis  of  nympho-mania  is  so  simple  that  the 
condition  is  generally  recognised  by  the  owners  or  cow-herds.  The 
only  difficult  point  lies  in  discovering  the  exact  cause.  Complete 
examination  of  the  genital  organs  per  rectum  and  per  vaginam  is 
absolutely  necessary  to  settle  this  question. 

Prognosis.  From  an  economic  standpoint  the  prognosis  is  gene- 
rally grave. 

Treatment.  The  treatment  varies  considerably,  according  to  the 
nature  of  the  lesion. 

In  mild  cases  where  nympho-mania  is  due  to  some  lesion  of  the 
clitoris  (balanitis,  hypertrophy,  or  tumour  formation),  the  radical 
treatment  consists  in   clitoridectomy.     The  operation  is  comparatively 


NYMPHO-MANIA. 


563 


>-— 


slight,  the  organ  being  removed  with  forceps  and  scissors,  or  with  a 
bistoury  after  the  animal  has  been  hobbled  or  placed  in  a  trevis. 
The  haemorrhage  which  follows  removal  of  the  clitoris  is  of  little  im- 
portance, and  after-treatment  simply  consists  in  lvee])ing  the  parts 
clean. 

Animals  so  treated  can  sometimes  be  preserved  for  breeding. 
When  nympho- 
mania  co-exists 
with,  and  is  a  de- 
layed consequence 
of,  either  chronic 
vaginitis  or  metri- 
tis localised  in  the 
neck  of  the  uterus, 
or,  again,  chronic 
metritis  of  the 
cavity  of  the  uterus, 
etc.,  the  treatment 
must  be  directed 
against  these 
diseases,  and  the 
nervous  condition 
may  be  sufficiently 
modified  to  render 
the  animals  useful 
for  breeding,  or  at 
least  for  slaughter, 
while  fattening  is 
easy. 

Similarly,  when 
the  nervous  condi- 
tion results  from  a 
lesion  of  the  ovary, 
improvement  will 
only  follow  re- 
moval of  the 
diseased  part.    The 

operation  is  similar  to  that  of  castration  of  the  female.  It  presents, 
however,  certain  added  difficulties,  in  consequence  of  the  size  of  the 
organs  and  of  the  al)normal  adhesions  which  often  occur.  Neverthe- 
less, these  difficulties  are  seldom  insurmountable. 

In  the  case  of  peri- uterine  disease  operation  is  difficult,  and  it  is 
better  to  slaughter  the  animal. 

o  o  2 


cai 

[ 


'v^ 


:l 


( 


Iv-^ 


J 


Fig.  236. — Specimen  of  lesious  found  in  nympho-mania. 
V,  Vagina  laid  open ;  Cm,  neck  of  tlie  uterus ;  0,0, 
ovaries ;  Qd,  right  horn  of  the  uterus  ;  C^,  left  horn  of 
the  uterus  ;    K,K,K,  peri-uterine  cysts. 


564  GENITAL    APPARATUS. 

Finally,  as  ma}'  occasionally  happen,  should  there  be  no  congenital 
lesion  capable  of  explaining  the  appearance  of  nympho-mania,  the 
disease  may  be  regarded  as  a  neurosis,  and  may  then  be  treated  by 
such  sedatives  as  the  bromides  of  potassium,  sodium  and  strontium, 
in  doses  of  2  to  3  drachms  per  day,  divided  into  two  or  three 
portions.  Bromide  of  camphor  also  gives  excellent  results  by  acting 
simultaneously  on  the  nervous  system  and  calming  excessive  genital 
irritation. 

The  above  method  of  treatment  is  much  preferable  to  performing 
clitoridectomy,  or  ovariotomy  as  a  kind  of  panacea,  although  certain 
writers  have  suggested  these  operations  without  taking  into  account 
the  special  local  conditions. 


CHAPTER    V. 
DISEASES    OF    THE    MAMMARY    GLANDS, 

In  animals  used  for  the  purpose  of  providing  milk,  viz.,  cows, 
goats,  and  milch  ewes,  diseases  of  the  mammary  glands  are  of  daily 
occurrence,  but  are  rare  in  those  in  which  the  mammary  function  is 
limited  to  the  nourishment  of  the  young,  such  as  the  mare,  female  ass, 
sow,  etc. 

In  order  clearly  to  understand  the  development  of  these  diseases, 
it  is  necessary  to  bear  in  mind  the  anatomical  construction  of  the 
organs,  for  which  purpose  we  may  take  as  a  type  the  mammary  gland  of 
the  cow,  which  is  the  most  complicated. 

The  udder  of  the  cow  is  of  hemispherical  shape.  It  is  situated  in 
the  inguinal  region,  and  is  composed  of  two  parts,  the  right  and  left, 
which  are  absolutely  independent  and  can  easily  be  isolated  from  each 
other  along  the  median  plane  throughout  their  extent.  The  mass  of 
parenchyma  is  enveloped  in  a  fibrous  envelope,  which  is  covered  with  a 
very  loose  layer  of  subcutaneous  connective  tissue.  Each  half  is  sub- 
divided into  two  quarters,  an  anterior  and  a  posterior  quarter.  Each 
quarter  again  represents  a  distinct  gland,  although  anatomical  separa- 
tion between  the  anterior  and  the  corresponding  posterior  quarter  would 
be  almost  impossible,  the  separating  fibro-connective  partition  being 
common  to  both  glands. 

In  very  good  milkers  it  sometimes  happens  that  two  small  supple- 
mentary glands  may  be  found  behind  the  posterior  quarters,  bringing 
up  the  total  number  to  six. 

Parenchyma.— Each  of  these  glands  is  provided  with  a  teat  contain- 
ing a  large  sinus.  Anatomically  the  mamma  consists  of  glandular  tissue 
arranged  like  a  bunch  of  grapes,  in  which  the  active  tissues  of  the  acini 
deliver  their  secretion  into  little  excretory  canals,  which  unite,  forming  a 
large  collecting  plexus.  The  collecting  canals,  or  galactophorous  canals, 
open  into  the  galactophorous  sinus,  which,  occupies  the  entire  depth  of 
the  teat  and  communicates  with  the  exterior  by  a  small  pore  provided 
with  a  sphincter.  The  interacinous  connective  tissue  of  the  udder  and 
the  subcutaneous  tissue  of  the  teat,  which  envelops  the  galactophorous 


566 


DISEASES   OF   THE   MAMMARY   GLANDS. 


VlCa 


G-.HM. 


sinus,  is  extremely  rich  in  elastic  filn-es,  enabling  the  organ  to  inidergo 

great  changes  in  volume  without  injury. 

Vessels.— The   mammae   are   supplied    by   two    great    arteries,   the 

mammary  arteries,  which  are  given  off  from  the  prepubic  arteries,  pass 

into  the  inguinal  canal,  and  penetrate  the  gland  hy  its  upper,  deep  face. 

Each   principal   lateral   artery   divides   into   two   trunks,   one   for    the 

anterior,  the  other  for  the  posterior  quarter. 

The  veins   which   collect   the   blood   from   the   mammae   form   two 

systems,  the   first   accompanying  the   mammary  arteries,  the   second, 

more     superficial, 
J -g  giving  rise  to  the 

anterior  sub- 
abdominal  mam- 
mary veins.  The 
arterio- venous 
plexus  of  the 
udder,  which  re- 
presents the  vas- 
cular pedicle  of  the 
organ,  penetrates 
the  gland,  near  a 
line  dividing  the 
posterior  and 
middle  thirds  of 
the  upper  surface, 
an  inch  or  so  in 
front  of  the  mam- 
mary  lymphatic 
gland. 

Lymphatics.— 
On  either  side  of 
the  middle  line  lies 

an  extremely  rich  lymphatic  plexus,  the  origin  of  which  is  to  be  found 

near  the  ends  of  the  teats  and  in  the  peri-acinous  spaces. 

The   superficial   collecting   vessels   are   dispersed   under    the    skin, 

perforate  the  fibrous  sheath  towards  the  base  of  the  teat,  and  anastomose 

with  one  another  on  the  surface  of  the  gland,  the  anastomosis   being 

most   intimate   between   those   of   the   same   quarter,  finally  emptying 

separately  by  two  large  trunks  into  the  retro-mammary  lymphatic  gland 

of  the  same  side. 

The  vessels  of  the  anterior  quarter  enter  the  l^anphatic  gland  at 

its  most  anterior  point ;  those  Of  the  posterior  quarter  join  it  a  little 

below. 


Fig.  237. — Schema  showing  the  structure  and  organisation  of 
the  udder.  Antero-posterior  section  showing  the  arrange- 
ment of  the  anterior  and  posterior  quarters  and  the  teats, 
skin,  transverse  partition,  etc.  GEM,  Eetro-mammary 
lymph  gland ;  Ljj.  lymphatics  of  the  posterior  quarter ; 
La,  lymphatics  of  the  anterior  quarter ;  LE,  efferent  lym- 
phatics ;  AM,  mammary  artery ;  VM,  mammary  vein ; 
VMrt,  anterior  mammary  vein  (subcutaneous  abdominal 
vein)  ;    C,   transverse  inter-mammary  septum. 


PHYSIOLOGICAL    ANOMALIES.  567 

The  retro-mammary  lymphatic  glands  are  two  in  number,  and  are 
situated  very  high  and  towards  the  back,  above  the  posterior  quarters 
and  close  to  the  perineum,  outside  the  fibrous  envelope  of  the  gland. 
They  are  sheltered  in  a  recess  excavated  within  the  depths  of  the  gland 
itself.  The  main  collecting  lymphatics  from  the  anterior  and  posterior 
quarters  enter  it  separately. 

The  lateral  efferent  vessels  are  divided  into  two  groups,  one 
of  which  ascends  vertically  in  the  ■  perineal  region,  towards  the 
lymphatic  glands  round  the  anus  :  the  other  passes  through  the  in- 
guinal canal  towards  the  sub-lumbar  region,  together  with  the  blood- 
vessels. 

The  mammary  nerves  are  two  in  number.  The  anterior  has  a 
downward  course  outside  the  fibrous  envelope  and  supplies  the  teat ; 
the  posterior  nerve  is  similarly  distributed.  In  other  domestic  female 
animals  which  have  only  two  mammae  the  general  arrangement  is 
precisely  the  same. 

PHYSIOLOGICAL    ANOMALIES. 

Imperforate  condition  of  the  Teat. — It  sometimes  happens  that 
although  the  udder  is  otherwise  well  formed,  the  teats,  or  more 
frequently  a  single  teat,  proves  to  be  imperforate.  Between  the  galac- 
tophorous  sinus  and  the  exterior,  opposite  the  sphincter,  a  little 
membrane  may  be  found  which  closes  the  teat  and  entirely  prevents 
the  contents  of  the  udder  from  escaping.  Its  existence  is  only  dis- 
covered when  the  animal  first  calves  and  lactation  commences.  Not  a 
drop  of  milk  can  be  withdrawn,  although  the  udder  is  swollen.  Local 
examination  readily  reveals  the  defect. 

Treatment  is  very  simple  and  effective,  the  membrane  being  per- 
forated with  the  end  of  a  milk  catheter. 

Contraction  of  the  Sphincter  {Atresia  of  the  Extremity  of  the  Teat), 
—Under  other  circumstances  the  teat  may  present  a  distinct  per- 
foration, and  yet  milking  may  be  impossible,  or  at  all  events  may  be 
extremely  difficult.  This  is  sometimes  due  to  contraction  of  the  sphincter, 
or  possibly  to  atresia  of  the  orifice. 

The  diagnosis  of  this  condition  is  easy,  but  the  outlook  is  not 
promising. 

Treatment  is  rather  difficult.  Some  operators  recommend  dividing 
the  terminal  sphincter  with  a  small,  specially-formed  bistouri  cache, 
provided  with  two  cutting  points.  The  operation  has  very  satisfactory 
immediate  results,  but  after  the  little  wounds  so  produced  have  healed, 
cicatricial  contraction  takes  place  around  the  orifice. 

Forcible  dilatation  is  far  preferable.  It  is  carried  out  in  the  same 
way  as  in  human  medicine,   where  the  sphincter  ani  or  the  orifice  of 


568  DISEASES   OF   THE   MAMMARY    GLANDS. 

the  uterus  has  to  be  dih^ted.  No  superficial  lesion  and  no  incision  is 
produced ;  the  result  is  therefore  more  permanent  (see  ' '  Operative 
Technique  ")• 

WOUNDS     OR     TRAUMATIC     LESIONS. 

CHAPS    AND    CRACKS. 

These  injuries  consist  in  little  transverse  or  oblique  wounds  of  the  teat. 

Causation.  In  free  milkers  the  udder  appears  completely  relaxed 
after  milking.  In  the  intervals  between  the  different  milkings,  however, 
the  quarters  become  swollen,  and  are  sometimes  so  distended  as  to  over- 
come the  resistance  of  the  sphincter  at  the  base  of  the  teat.  The  teats 
are  then  greatly  elongated,  and,  despite  the  richness  of  the  tissues  in 
elastic  fibres,  this  distension  leads  to  little  superficial  epidermic  fissures. 

These  small  lesions  are  unimportant,  but  if  they  become  infected 
by  contact  with  the  litter  they  granulate  and  suppurate,  so  that  grave 
complications  may  eventually  follow. 

The  wounds  caused  by  the  calves'  teeth  when  sucking,  or  simply  by 
the  rough  way  in  which  the  little  animal  seizes  the  teat,  may  produce 
similar  accidents. 

Symptoms.  The  teat  shows  one  or  more  little  transverse  fissures, 
a  few  millimetres  to  a  centimetre  or  more  in  length.  The  base  of  the 
fissure  appears  of  a  reddish  or  brownish-red  colour,  and  has  thickened, 
indurated,  painful,  discharging  or  suppurating  margins.  Local  sensi- 
tiveness may  be  either  slight  or  very  pronounced.  In  the  latter  case, 
the  patients  resist  being  milked,  and  even  refuse  to  let  the  calf  suck. 

Diagnosis.     The  diagnosis  is  extremely  simple. 

In  a  general  sense  the  prognosis  is  favourable,  but  nevertheless  the 
local  infection  may  extend  and  become  generalised,  thus  giving  rise  to 
interstitial  mammitis,  sometimes  of  a  very  grave  character.  On  the 
other  hand,  the  sensitiveness  may  of  itself  render  milking  difficult  or 
impossible,  and  thus  cause  serious  distension  of  the  gland  with  milk. 

Treatment.  As  both  sucking  and  milking  aggravate  the  lesions,  they 
should  be  prevented  by  the  insertion  of  a  milk  catheter. 

The  surface  of  the  udder  and  the  wounds  should  be  cleansed  with 
an  antiseptic  solution  and  be  dressed  with  a  20  per  cent,  campho- 
rated vaseline  or  with  carbolic  or  iodoform  ointment,  to  favour  healing. 
If  the  cracks  produce  excessive  sensitiveness  a  small  quantity  of 
orthoform  may  be  added  to  the  camphor  ointment.  Before  the  milk 
catheter  is  inserted,  the  teat  should  be  very  carefully  cleansed  with 
boiled  water  and  the  catheter  steriUsed  by  boiling.  Neglect  of  these 
precautions  may  result  in  infection  of  the  galactophorous  sinus  and 
mammitis. 


MILK   FISTULA. 


569 


the  permanent  discharge  of 
accordino;  to  circumstances. 


MILK     FISTULA. 

Causation.  Any  accidental  injury  to  the  udder  which  estabUshes 
connection  between  the  galactophorous  canals  or  the  galactophorous 
sinus  and  the  exterior  may  give  rise  to  milk  fistula,  if  the  injury 
occur  during  lactation. 

Apart  from  lactation  these  wounds  may  be  grave,  though  if  care- 
fully treated  they  heal  without  comphcation.  During  lactation,  on 
the  contrary,  the  miWi  escapes  permanently  from  the  injured  spot, 
cicatrisation  cannot   occur,    and   a   fistula   forms. 

Symptoms.  The  principal  symptom  is 
milk.  The  fistula  may  be  large  or  small 
In  rare  instances  it  is 
situated  on  the  udder 
itself,  but  it  is  com- 
monest on  the  teat. 
Milk  may  escape  in 
mere  drops  or,  on  the 
other  hand,  in  con- 
siderable quantities. 

Diagnosis.  The 
diagnosis  presents  no 
difticulty. 

Prognosis.  The 
prognosis  is  grave  so 
far  as  the  loss  of  milk 
is  concerned,  although 
the  lesion  has  no 
effect  on  the  general  health 
it  may  cause  the  interior 


Fig.  238. — Milk  fistulte.  1,  Deep  suture — schema  show- 
ing the  course  of  the  suture ;  FL,  base  of  the  fistula  ; 
8.,  suture  ;  2,  superficial  interrupted  suture. 


,  It  is  particularly  serious,  however,  because 
to  become  infected,  and  an  acute  parenchy- 
matous mammitis  may  thus  be  set  up.  It  must  also  be  borne  in  mind 
that  old  fistulfe  are  much  more  difficult  to  obliterate  than  recent  ones. 

Treatment  is  much  more  troublesome  than  might  at  first  be  thought, 
the  great  obstacle  to  repair  being  the  continual  secretion  and  discharge 
of  milk. 

At  first,  attempts  should  be  made  to  re-establish  and  render  permanent 
the  natural  method  of  discharge.  This  can  be  efiected  by  inserting  an 
aseptic  milk  catheter  and  fixing  it  in  position  with  a  little  pitch  bandage. 

The  course  of  the  fistula  is  then  cleansed,  curetted,  and  rendered 
aseptic  in  some  way,  as  for  example  by  washing  with  boiled  salt  solution 
and  dilute  hydroxyl. 

As  there  is  little  hope  of  obliterating  the  fistula  by  merely  suturing 
the  skin,  its  course  should   first  be  closed  by  passing  one  or  two  deep 


570  DISEASES   OF   THE   MAMMARY   GLANDS. 

sutures  without  touching  the  external  orifice  and  without  passing  over 
it  (Fig.  238).  The  discharge  of  fluid  heing  then  entirely  stopped,  the 
external  portion  of  the  fistula  is  thoroughly  cleansed,  powdered  with 
iodoform,  and  finally  closed  with  external,  closely-applied  sutures.  These 
sutures  are  protected  with  a  little  cotton-wool  or  collodion  dressing,  and 
healing  then  almost  invariably  occurs. 

The  animal  should  be  given  a  very  clean  bed,  and  closely  watched 
to  prevent  it  tearing  out  the  milk  catheter.  On  the  fourth  or  fifth  day 
the  catheter  is  removed,  and  is  afterwards  only  used  at  intervals. 

As  all  the  sutures  can  be  of  aseptic  catgtit  or  silk,  there  is  no 
necessity  to  trouble  about  their  removal.  The  dressing  can  be  left 
until  it  falls  away  of  itself. 

INFLAMMATORY     DISEASES. 
CONGESTION   OF    THE    UDDEK. 

Congestion — i.e.,  distension  of  the  vascular  plexus  as  a  consequence  of 
momentary  stasis,  vaso-motor  disturbance,  or  paralysis  of  the  little  vessels 
in  the  udder — can  only  be  regarded  as  pathological  in  cases  when  it  pre- 
cedes mammitis  or  when  it  results  from  prolonged  neglect  to  milk  the 
animal,  external  irritation,  etc.  It  was  studied  long  ago  by  H.  d'Arboval, 
Gelle,  Delafond,  Trasbot,  Lucet,  etc. 

Jt  also  occurs,  but  in  a  form  which  might  almost  be  termed  physio- 
logical, after  the  first  parturition  in  the  large  milch  breeds,  where  the 
rush  of  blood  which  precedes  secretion  is  very  great. 

Symptoms.  The  udder  is  swollen,  tense,  doughy,  shining,  and 
a3dematous,  not  very  painful  on  pressure,  but  sufficiently  so  to  interfere 
with  movement.  The  general  condition  is  little  altered,  but  the  tem- 
perature of  the  udder  is  abnormally  high. 

]\[anipulation  reveals  the  existence  of  more  or  less  oedema,  the  parts 
preserving  the  imprint  of  the  finger.  Sometimes  this  oedema  extends 
along  the  abdominal  wall  in  front  of  the  udder.  The  milk  may  be 
grumous  or  even  sanguinolent.  The  congestive  state  continues  for 
some  days,  eight  to  ten  at  the  most,  and  may  gradually  disappear  by 
resolution.  Not  infrequently  it  terminates  in  acute  mammitis  after 
forty-eight  hours. 

Lesions.  In  simple  mammary  congestion  the  lesions  are  confined 
to  excessive  dilatation  of  the  peri-acinous  capillary  vessels,  and  extrava- 
sation into  the  connective  tissue.  On  section  the  tissue  has  a  dark-red 
appearance. 

Diagnosis.     The  diagnosis  is  simple. 

Prognosis.  The  prognosis  is  less  alarming  than  might  at  first  sight 
be  supposed. 


MAMMTTIS. 


571 


The  treatment  consists  simply  in  hygienic  precautions,  frequent 
milking,  emollient,  sedative  applications  to  the  udder,  and  frequent 
washing.    As  far  as  possible  the  use  of  milk  catheters  should  be  avoided. 

Boric  vaseline  and  belladonna  ointment  may  be  recommended.  In 
very  serious  cases  blood  can  be  withdrawn  from  the  jugular.  This  is 
better  than  bleeding  from  the  mammary  vein,  which  always  entails  the 
risk  of  thrombus  formation. 


MAMMITIS. 

Under  the  heading  "  mammitis  "  are  included  different  forms  of  in- 
flammation of  the  mammary  tissue,  whether  such  inflammation  attack 
the  parenchyma  of  the  gland  or  the  interstitial  tissue.  Generally 
the  whole  gland  is  invaded  at  the  end  of  a  few  days,  whatever 
the  point  of  origin,  and  the  inflammation  is  therefore  of  a  mixed 
character. 

Mammitis  has  been  recognised  from  very  early  times.  In  his 
researches  on  "contagious  mammitis"  Nocard  in  1884  showed  that 
infection  was  the  principal  factor  in  its  evolution. 

Numerous  classifications,  based  on  the  causes  or  on  the  pathological 
anatomy  of  the  condition,  have  been  suggested  ;  but  most  appear  too 
rigid,  and  therefore,  without  discussing  them,  we  confine  ourselves  to 
giving  the   following  resume  :^— 


Rainard  (1845) 


Lafosse  (1856)  .  . 
Trasbot  (1883) . . 

Saint  Cyr  (1874) 
Violet  (1888)      .  . 


Liicet  (1891) 


Lacteal  engorgmeiit. 
Cellulitis  of  the  i;dder. 
Mammitis .  . 


Mammitis . 


Mammitis . 


Primary   mammitis 
perly  so-called) .  . 


[  Acute. 

(  Chronic. 

I  Acute. 

(  Chronic. 

/  Catarrhal. 

\  Phlegmonous  or  interstitial. 

\  Parenchymatous. 


(pro- 


Symptomatic  mammitis.  . 


Acute 


Chronic . 


Acute 


Chronic .  . 


Galactogenous. 


i  Lymphogenous. 
(  Galactogenous. 
I  Lymphogenous. 
f  Haematogenous. 
I  Lymphogenous. 
f  Haematogenous. 
I  Lymphogenous. 


All  these  classifications  are  Justified  by  the  guiding  ideas  of  the 
writers,  yet,  as  in  every  case  of  attempted  systematisation,  they  have 
the  disadvantage  of  not  being  in  entire  agreement  with  clinical 
experience. 

For  instance,  the  diflerences  between  catarrhal  and  parenchymatous 


572  DISEASES   OF   THE   MAMMARY   GLANDS. 

forms  of  mammitis  are  only  of  degree,  and  it  is  difficult,  therefore,  to 
see  why  they  should  be  divided  into  two  distinct  varieties.  The  differ- 
ence is  in  regard  to  the  i^rognosis. 

Similarly  in  practice  it  is  difficult  and  sometimes  impossible  to  dis- 
tinguish between  an  interstitial  and  a  parenchymatous  mammitis, 
because  all  the  tissues  of  the  gland  may  be  involved  at  a  given 
moment.  The  only  factor  which  allows  of  differentiation  is  the  dis- 
covery of  the  point  from  which  infection  took  place.  Finally,  it  is 
sometimes  so  difficult  to  distinguish  between  galactogenous  and  lym- 
phogenous mammitis  that  the  attempt  has  had  to  be  abandoned.  In 
gangrenous  mammitis  of  milch  ewes,  for  example,  the  infective  organism 
is  found  not  only  in  the  sinus  and  the  galactophorous  canals,  but 
also  in  the  serosity  of  the  interstitial  tissue  and  of  the  perimammary 
cedema. 

Without  doubt  the  causative  agent  of  mammitis  may  enter  the 
gland  by  three  principal  channels — the  galactophorous  sinus,  the  lym- 
phatic plexus  (after  some  injury),  and  the  blood  circulation.  But  from 
the  clinical  standpoint  it  is  not  at  all  necessary  to  identify  all  the  causes 
in  order  to  establish  the  classification. 

The  symptoms  allow  of  a  division  only  into  acute  and  chronic 
mammitis.  Careful  examination  of  the  general  condition  of  the  patients 
will  afterwards  allow  cases  of  primary  mammitis  to  be  distinguished 
from  secondary  or  symptomatic  mammitis  such  as  occurs  in  tuberculosis. 
Finally,  consideration  of  the  conditions  under  which  a  particular  case 
of  mammitis  has  appeared,  and  study  of  the  symj)toms  in  detail 
(peculiarities  of  the  milk,  local  temperature,  hardness  of  the  tissues, 
cedematous  infiltration,  etc.)  will  in  most  cases  indicate  whether  the 
mammitis  be  parenchymatous  or  interstitial. 

This  system  really  differs  little  from  that  adopted  by  Lucet  in  his 
work  on  Mammitis. 

The  classification  adopted  in  the  following  pages  is  as  follows  : — 


f  Acute . . 


j  Parenchymatous  or  galactogenous. 
'   -^  ■  ■  1  Interstitial  or  lymphogenous. 


Mammitis 


Secondary     or  f  Haematogenous. 
symptomatic.  I  Galactogenous. 
Simple. 

Parenchymatous. 
Chronic  .  .   J  ^  Interstitial. 

f  Parenchymatous. 
i  Interstitial. 

We  shall  leave  on  one  side  everything  concerning  secondary  sj^up- 
tomatic  mammitis,  the  study  of  which  merges  into  that  of  the  general 
diseases  from  which  it  arises. 


ACUTE    MAMMITIS.  573 


ACUTE    MAMMITIS. 

Causation.  The  general  cause  of  acute  mammitis,  like  that  of 
chronic  mammitis,  is  infection  by  pathogenic  organisms,  whether  such 
organisms  enter  by  the  usual  natural  path,  viz.,  the  galactophorous 
sinus  and  excretory  apparatus,  by  the  lymphatic  path,  owing  to  some 
accidental  injury,  or,  again,  by  the  blood  circulation. 

Infection  of  the  lymphatics  undoubtedly  plays  a  part  in  superficial 
and  interstitial  inflammations,  and  it  is  proved  that  certain  micro- 
organisms may  pass  into  the  milk,  as  it  has  been  proved  that  they 
pass  through  the  kidney. 

But  if  infection  is  the  determining  cause,  certain  secondary  favour- 
ing influences  must  not  be  overlooked. 

Thus  lactation  is  an  almost  indispensable  condition.  It  is  true 
that  some  cases  of  mammary  inflammation  apart  from  lactation  have 
been  described,  but  they  have  been  the  result  of  violence,  accidental 
or  mechanical. 

Accumulation  of  milk  in  the  udder  (overstocking)  has  unquestion- 
ably a  certain  influence  in  the  large  milk-yielding  animals,  not  because 
it  directly  produces  inflammation,  but  because  milk  then  escapes  spon- 
taneously ;  and  as  the  udder  cannot  be  entirely  evacuated  without 
external  assistance,  the  entrance  is  kept  permanently  open  for  the 
passage  of  germs,  which  are  freely  transferred  to  the  teat  from  the 
litter  and  surrounding  objects. 

Cold,  or  rather  chills,  also  act  in  a  complex  manner,  particularly 
by  disturbing  vaso-motor  control.  Diflerent  forms  of  mechanical 
violence,  such  as  blows,  crushing  strains,  wounds,  etc.,  may  immediately 
and  directly  set  up  local  or  general  inflammation. 

Bacteriological  investigation  has  proved  that  numerous  and  varied 
micro-organisms  can  be  found  in  the  milk  or  interstitial  exudates  in 
cases  of  mammitis,  but  only  a  few  special  forms  have  been  proved  to 
be  specific  :  streptococcus  of  contagious  mammitis  of  milch  cows,  and 
micrococcus  of  contagious  gangrenous  mammitis  of  ewes  (Nocard). 

Pathology.  The  pathogenic  results  produced  by  infective  organisms 
depend  on  their  number  and  power  of  reproduction,  and  on  the  activity 
of  their  life  products. 

The  most  immediate  and  regular  result  of  acute  mammary  infec- 
tion is  coagulation  of  the  milk  within  the  udder  by  decomposition  of 
the  lactose,  and  the  formation  of  lactic  or  even  of  butyric  acid.  The 
acini  and  excretory  canals  are  dilated  by  coagula,  and  can  no  longer 
expel  their  products  of  secretion,  so  that  the  colonies  of  micro-organisms 
develop  there  in  full  security.  The  active  epithelial  cells  undergo 
granular  degeneration  and  disappear,   whilst  the  walls  of   the   glands 


574  DISEASES    OF   THE    MAMMARY    GLANDS. 

become  infiltrated  and  large  numbers  of  leucocytes  are  poured  forth 
around  the  glanduUir  culs-de-sac. 

The  tissues  being  thus  affected,  the  virulent  organisms  penetrate 
from  the  acini  into  the  interstitial  tissue,  and  from  this  time  onwards 
the  lesions  become  mixed. 

Inversely,  should  infection  originate  in  the  lymphatic  spaces,  a 
time  arrives  when  the  organisms  make  their  way  from  the  interstitial 
tissue  into  the  acini,  with  a  similar  result  in  the  end. 

The  development  of  the  lesions  may  be  arrested  or  may  pass  on  to 
suppuration,  or  even  gangrene,  of  the  parenchymatous  lobules.  Cases 
happen  in  which  infection  is  so  rapid  and  severe  that  the  successive 
stages  cannot  even  be  identified,  and  gangrene  appears  without  any  pre- 
liminary stages  at  all.     Lucidly  the  commonest  forms  are  less  serious. 

Symptoms.  Acute  mammitis  is  characterised  by  its  sudden  appear- 
ance, more  or  less  acute  general  symptoms  (dulness,  fever,  and  loss 
of  appetite),  and  variable  local  symptoms.  When  the  practitioner  is 
able  to  follow  the  development  of  the  disease  throughout,  he  may 
sometimes  distinguish  well-marked  signs,  which  permit  the  two  clinical 
varieties  to  be  distinguished. 

A.  Interstitial  Mammitis. — This  form,  which  might  perhaps  also 
be  termed  peri-mammitis  when  it  primarily  affects  the  subcutaneous 
lymphatic  spaces,  has  also  received  the  names  of  phlegmonous  and 
lymphogenous  mammitis. 

It  is  characterised  by  alarming  general  symptoms,  and  particularly 
by  a  rise  in  temperature  of  2°,  4*^,  or  even  5°  Fahr.,  with  all  its  con- 
sequences, such  as  loss  of  appetite,  stoppage  of  rumination,  acceleration 
of  breathing  and  circulation,  slight  tympanites,  constipation,  and  by 
the  thrusting  of  the  hind  limb  on  the  affected  side  away  from  the 
centre  line.     The  animals  groan  when  forced  to  move. 

These  symptoms  sometimes  precede  by  a  considerable  interval  the 
appearance  of  the  local  changes,  which  consist  in  painful  swelling  of 
one  or  two  quarters,  rarely  of  more. 

The  peri-mammary  subcutaneous  tissue  is  infiltrated,  cedematous, 
painful  on  palpation  and  preserves  the  imprint  of  the  finger.  The  teat 
is  tense,  swollen,  very  tender,  and  of  reddish  colour.  In  the  grave 
forms  the  swelling  extends  forwards  under  the  abdomen  in  the  direc- 
tion of  the  umbilicus,  and  backwards  towards  the  perineum.  The  local 
temperature  is  abnormally  high,  the  secretion  of  milk  in  the  diseased 
gland  is  modified  or  checked,  and  sometimes  this  phenomenon  extends 
by  reflex  action  to  the  neighbouring  quarters,  although  the  latter  may 
not  themselves  be  affected.  The  inflammation  rarely  extends  from  one 
quarter  to  another,  because  the  lymphatic  plexuses  do  not  anastomose 
(Fig.  237). 


ACUTE    MAMMITIS.  575 

The  animals  lose  appetite  and  fall  away  rapidly. 

Eesolution  may  occur  after  from  five  to  eight  days.  By  degrees 
all  the  symptoms  then  become  less  marked.  The  appetite  returns, 
pain  diminishes,  the  fever  drops,  and  the  lesions  gradually  disappear, 
but  the  yield  of  milk  rarely  regains  its  former  amount. 

Suppuration  may  occur ;  sometimes  a  superficial  subcutaneous 
abscess  forms,  more  rarely,  a  deep-seated,  interstitial  abscess,  originat- 
ing in  the  connective  tissue  or  lymphatic  spaces.  With  a  superficial 
abscess,  the  local  symptoms  again  revive  to  a  slight  extent ;  these  are 
present  in  a  more  marked  degree  where  the  abscess  is  deep-seated. 
An  extremely  sensitive  cedematous  swelling  forms,  the  skin  covering 
which  is  at  some  point  of  a  deep- red  tint,  whilst  fluctuation  gradually 
appears. 

In  cases  of  deep-seated  abscess  formation  the  general  condition 
becomes  alarming  ;  the  affected  quarter  is  tense  throughout,  hard  and 
very  sensitive. 

Deep-seated  suppuration  is  difticult  to  detect,  and  exploratory 
punctures  with  a  fine  needle  may  be  necessary  before  the  diagnosis 
can  be  made. 

Local  or  diffuse  gangrene  forms  a  rare  complication.  It  is  due  to 
the  vessels  of  one  or  several  glandular  lobules  becoming  obliterated 
or  thrombosed. 

Such  a  termination  is  indicated  by  extreme  aggravation  of  the  general 
symptoms,  feebleness  of  the  heart  and  great  weakness  of  the  patients,  who 
fall  into  a  condition  of  coma.  Locally  the  udder  remains  cedematous, 
the  skin  becomes  of  a  blackish-violet  colour,  whilst  the  local  temperature 
falls  and  the  animals  die  from  exhaustion  and  intoxication. 

Parenchymatous  Mammitis.  —  Parenchymatous  mammitis  when 
mild  is  also  termed  catarrhal  mammitis.  It  is  in  reality  true 
primary  mammitis  ;  interstitial  being  primarily  and  practically  peri- 
mammary  lymphangitis. 

In  this  case  infection  occurs  through  the  teat,  and  may  be  locahsed 
in  the  sinus  or  excretory  apparatus,  giving  rise  to  galactophoritis,  but. 
it  usually  extends  to  the  acini.  Inflammation  of  the  mammary  tissue 
is  therefore  direct  and  primary.  It  rapidly  extends,  however,  through 
the  glandular  wall  into  the  interstitial  tissue,  thus  setting  up  (from 
the  anatomo-pathological  standpoint)  a  mixed  mammitis.  Clinical 
distinction  between  this  form  and  interstitial  mammitis  is  at  first 
easy. 

The  symptoms  usually  occur  in  the  following  order  : — Swelling  of 
the  affected  quarter  or  quarters ;  appreciable  increase  in  size  and 
sensitiveness ;  the  presence  at  first  of  curdled  milk  in  the  galacto- 
phorous  sinus,  then  of  clots  mixed  with    slightly  red  tinged  serosity; 


576  DISEASES   OF   THE   MAMMARY    GLANDS. 

complete    cessation    of    the    yield    of    milk,    and    suppuration    in    the 
secreting  portions  of  the  gland. 

The  general  symptoms  appear  only  after  the  objective  signs,  and 
vary  greatly  in  intensity,  according  to  the  ease.  As  in  'the  interstitial 
form,  there  may  be  marked  fever,  loss  of  appetite,  cessation  of  rumi- 
nation, groaning,  and  difficulty  in  walking. 

In  some  grave  forms,  where  development  is  peracute,  infection 
spreads  rapidly  from  the  glandular  to  the  interstitial  tissue,  and 
subcutaneous,  sub-abdominal,  or  perineal  interstitial  cedema  occurs 
secondarily. 

The  udder  is  turgid,  tense,  shining,  and  of  reddish-violet  colour  in 
places,  as  if  a  deep-seated  abscess  were  developing. 

Pressure  on  the  galactophorous  sinus  causes  the  flow  of  reddish-grey 
milk,  sometimes  fcetid  or  of  gangrenous  odour.  The  animals  seem 
exhausted,  show  signs  of  profound  intoxication,  are  unable  to  rise,  and 
appear  paralysed. 

But  besides  these  grave  forms  are  others,  in  which  the  patients  seem 
scarcely  to  suffer  :  appetite  is  preserved  and  all  the  vital  functions  are 
in  full  activity.     Only  the  local  signs  are  of  importance. 

This  variability  in  the  clinical  symptoms  of  acute  forms  of  mammitis 
is  entirely  due  to  differences  in  the  pathogenic  infecting  organisms. 

Parenchymatous  mammitis  may  end  in  resolution  in  three  to  four 
days,  with  progressive  but  slow  return  to  the  physiological  condition. 
This  termination  is  announced  by  the  gradual  disappearance  of  all 
the  symptoms  and  the  return  of  milk  secretion.  It  is,  however,  quite 
exceptional  for  the  former  condition  to  be  fully  restored,  and  in  many 
cases  the  affected  quarter  must  be  regarded  as  lost  from  the  physio- 
logical standpoint. 

It  gradually  becomes  hardened,  sclerotic  and  atrophied. 

Suppuration  is  very  common.  It  attacks  the  galactophorous  sinus, 
the  excretory  canals,  and  even  the  acini.  If  obstructions  occur  in  the 
course  of  the  collecting  vessels,  or  if  evacuation  is  not  artificially 
.stimulated  by  milking,  the  pus  collects  in  the  depths  of  the  gland, 
and  enormous  diffuse  abscesses  may  form  at  the  expense  of  the 
mammary  tissue. 

Circumscribed  or  diffuse  gangrene,  as  a  primary  condition,  is  rarer. 
Infective  organisms  rapidly  invade  even  the  depths  of  the  gland,  the 
interstitial  and  subcutaneous  tissue,  and  thrombosis  due  to  infection 
or  intoxication  occurs,  followed  by  gangrene.  Death  results  from 
infection  or  intoxication. 

Complications  such  as  necrosis  of  the  abdominal  tunic,  of  the 
fibrous  tissue  enveloping  the  mamma,  and  of  the  muscular  layers  on 
the  inner  surface  of  the  thighs,  may  occur  in  the  suppurative  forms. 


Acute  mamMitis.  577 

Diagnosis.  The  diagnosis  of  acute  mammitis  is  easy,  and  the  inter- 
stitial forms  (mammary  lymphangitis)  can  he  distinguished  from  the 
parenchymatous  forms  very  early  in  the  attack. 

Careful  examination  suffices  to  differentiate  hetween  this  condition 
and  mammary  congestion  or  primary  chronic  mammitis.  The  exami- 
nation, however,  must  he  much  more  thorough  and  searching  when  A 
specific  disease  (such  as  tuberculous  mammitis)  is  in  question. 

Prognosis.  The  prognosis  of  acute  mammitis  is  always  grave, 
whatever  form  the  disease  may  assume,  for,  if  the  animal's  life  is  not 
invariably  endangered,  its  economic  value  is  always  affected.  More- 
over, should  superficial  or  deep-seated  abscesses  form,  prolonged 
suppuration  may  follow,  resulting  in  loss  of  condition  and  enormous 
depreciation. 

Lesions.  The  lesions  of  interstitial  mammitis  are  similar  to  those 
of  ordinary  lymphangitis,  the  condition  originating  near  the  teat  and 
gradually  extending  to  the  layers  of  connective  tissue  between  the 
acini,  mammse,  etc. 

In  the  parenchymatous  form  the  inflammation  may  remain  partial, 
and  be  localised  in  particular  tracts  of  glandular  tissue.  The  secreting 
epithelium,  when  infected,  exhibits  cloudy  swelling,  becomes  loosened, 
and  disappears  ;  the  margin  of  the  gland  and  the  interstitial  divisions 
become  infiltrated  with  enormous  numbers  of  white  blood  corpuscles, 
and  are  the  seat  of  suppurative  processes  which  end  in  the  production 
of  small  acinous  abscesses.  By  the  union  of  neighbouring  abscesses 
large  branching  collections  of  pus  are  produced,  and  lead  to  partial  or 
total  destruction  of  tracts  of  the  parenchyma,  of  the  connective  tissue 
divisions,  vessels  and  aponeuroses. 

The  abscess  tends  to  break  through  the  skin,  which  becomes  inflamed 
and  ulcerated,  or,  when  the  micro-organisms  are  of  slight  virulence,  the 
tissues  may  react,  so  that  the  abscess  becomes  surrounded  with  a  thick 
indurated  wall,  and  finally  encysted. 

Treatment.  Very  numerous  methods  of  treatment  have  been  pro- 
posed, an  admission  which,  in  itself,  suggests  that  no  perfect  one  has 
been  discovered.  No  infallible  system,  in  fact,  exists  of  arresting  the 
disease  and  restoring  the  parts  to  their  normal  condition. 

From  a  prophylactic  standpoint,  mammitis  can  be  avoided  by  placing 
the  animals  under  proper  hygienic  conditions,  paying  special  attention 
to  cleanliness,  avoiding  over-stocking,  and  treating  excoriations  or  in- 
juries to  the  teat  or  udder  as  soon  as  they  appear. 

Once  acute  mammitis  has  developed,  general  and  local  treatment 
must  both  be  attempted. 

The  older  practitioners  were  in  the  habit  of  bleeding  from  the 
mammary  or  jugular  vein.     Since  their  time,  however,  objections  have 

D.C.  P  P 


578  DISEASES   OF   THE   MAMMARY    GLANDS. 

been  made  to  l:)leeding  because  acute  mammitis  bas  been  proved  to  be 
of  an  infectious  character,  and,  therefore,  it  is  undesirable  to  lower 
the  patients'  resisting  power. 

This  reasoning,  however,  appears  to  be  erroneous.  Little  by  little 
the  advantages  of  bleeding,  both  in  intoxications  and  infections,  have 
been  recognised,  and  one  thing  at  least  is  beyond  dispute,  namely,  its 
action  on  fever.  Undoubtedly,  it  must  not  be  resorted  to  without 
judgment,  nor  should  it  be  freely  employed  in  debilitated  animals ; 
but  in  well-nourished  patients  its  effect  on  fever  and  on  the  accom- 
panying respiratory  and  circulatory  disturbance  is  immediate. 
We,  therefore,  recommend  moderate  bleeding  from  the  jugular. 
Bleeding  from  the  mammary  vein  entails  too  great  a  risk  of  infection 
to  be  commendable. 

Purgatives  and  diuretics  diminish  or  prevent  accidents  such  as 
intoxication  and  the  complications  resulting  from  temporary  suspen- 
sion of  the  digestive  function. 

Local  treatment  is  more  or  less  efficacious  in  mammary  infection. 
To  relieve  pain  and  check  infection  it  should  be  of  an  emollient  and 
antiseptic  character.  Ointments  containing  10  per  cent,  of  carbolic 
acid,  boric  acid  or  iodine,  or  12|^  per  cent,  of  camphor,  opium  or 
belladonna,  are  of  real  service  during  the  first  stages,  particularly  of 
mammary  lymphangitis  and  interstitial  mammitis. 

Repeated  applications  of  10  per  cent,  carbolic-glycerine  have  similar 
advantages. 

In  the  less  acute  forms  originating  in  the  parenchymatous  tissue, 
mild  ointments  of  plumbic  iodide,  Goulard's  extract,  or  mercury 
may  also  be  used  if  precautions  are  taken  to  prevent  the  animals 
from  licking,  and  so  poisoning  themselves. 

When  the  tendency  to  suppuration  is  marked,  vesicants  hasten 
the  development  of  the  abscess  and  facilitate  puncture.  The  most 
commonly  used  are  the  33  per  cent,  tartar  emetic  ointment  or  the 
10  per  cent,  biniodide  of  mercury  ointment. 

If,  on  the  other  hand,  the  mammitis  is  of  the  interstitial  type, 
with  severe  subcutaneous  oedema,  extending  over  the  belly  and 
towards  the  perineum,  good  results  often  follow  deep  firing  in  points 
over  the  swollen  region.  The  points  should  be  widely  spaced,  venous 
branches  being  avoided.  In  this  way  numerous  ducts  are  formed  by 
by  wdiich  the  toxic  and  septic  liquid  which  causes  the  cedema  is  enabled 
to  escape. 

This  method  of  treatment  can  be  supplemented  by  the  simultaneous 
use  of  antiseptic  ointments. 

Finally,  in  mammitis  of  the  parenchymatous  type,  wdiere  there 
is   no   marked    tendency    to    invade    the   interstitial   tissue,    the   most 


ACUTE   MAMMITIS.  579 

important  point  is  to  wash  out  the  interior  of  the  gland,  and  even 
the  acini  as  far  as  possible,  with  antiseptic  fluids.  Practically  this  is 
difficult  to  effect,  because  such  irrigation  must  be  performed  asepti- 
cally,  and  cannot  properly  be  left  to  the  cowmen. 

In  current  practice,  therefore,  one  often  has  to  be  content  with 
stripping  the  udder  every  hour.  Milk  clots  which  accumulate  in  the 
sinuses  and  galactophorous  canals  are  broken  down  by  soft  pressure, 
and  withdrawn  with  more  or  less  difficulty.  By  repeated  milking  they 
are  prevented  from  accumulating  in  the  galactophorous  sinus  and  canals, 
a  very  important  point.  Neglect  of  this  precaution  enables  the  colonies 
of  micro-organisms  to  develop  uninterruptedly  in  the  culs-de-sac,  where- 
upon the  coagula  formed  of  caseine  obstruct  the  excretory  channels  and 
complications  develop  despite  all  external  treatment. 

By  repeated  friction  of  the  udder  as  in  milking  the  advantages 
that  would  be  produced  by  washing  out  the  gland  from  the  direction 
of  the  acini  are  secured,  and  thus  the  ascending  infection  is  checked. 

The  diseased  udder  must  always  be  emptied  before  making  anti- 
septic injections,  which  would  otherwise  be  useless. 

Should  the  practitioner  decide  to  face  the  practical  difficulties  of  in- 
jections, he  must  take  care  that  his  instruments  are  aseptic ;  that  the 
solutions  employed  are  always  at  or  about  bodily  temperature ;  that 
these  solutions  are  incapable  of  irritating  even  tissues  so  tender  as  the 
epithelium  of  the  acini  or  of  the  galactophorous  canals ;  and,  finally,  that 
the  drugs  employed  will  not  coagulate  the  milk  within  the  gland. 

Bearing  in  mind  these  points,  the  practitioner  will  do  well  to  re- 
strict himself  to  the  use  either  of  boiled  water,  physiological  salt 
solution  ('9  per  cent.) ;  alkaline  3  per  cent,  solution  of  borate  of  soda ; 
or  *05  per  cent,  of  fluoride  of  sodium.  Every  precaution  having  been 
taken,  from  12  to  20  ounces  of  liquid  can  be  injected  into  each 
quarter,  according  to  its  size.  The  solutions  should  be  made  to  pene- 
trate as  far  as  possible  into  all  portions  of  the  gland  by  gently 
manipulating  the  parts,  and  should  again  be  withdrawn  in  about  a 
quarter  of  an  hour. 

It  must  always  be  remembered  that  failure  to  observe  the  above 
precautions  may  make  matters  worse  instead  of  better,  and  therefore 
that  intra-mammary  injections  can  only  be  of  value  when  carried  out 
by  a  skilled  person. 

In  otherwise  hopeless  cases  there  remains  as  a  last  resort  total  or 
partial  ablation  of  the  mamma.  This  operation  is  advisable  in  cases 
of  diffuse  gangrene,  or  of  intense  massive  suppuration,  where  there  is 
imminent  danger  of  death  from  infection. 

Directions  for  its  performance  will  be  found  in  Moller  and  Dollar's 
"Eegional  Surgery"  (uniform  with  the  present  volume),  p.  454. 

pp  2 


580  DISEASES   OF   THE   MAMMARY   GLANDS. 

CONTAGIOUS    MAMMITIS    IN    MILCH    COWS. 

Although  its  cause  was  unknown  before  the  investigations  of 
Noeard  and  IMollereau  in  1884,  this  disease  is  of  very  common 
occurrence  in  England,  in  large  dairies  in  the  environs  of  Paris,  and 
is  also  seen,  though  more  rarely,  in  Normandy,  in  Brie  and  the  Soisson- 
nais,  causing  serious  losses  on  account  of  its  transmissibility. 

It  had  been  described  in  Germany  by  Gerlach  as  early  as  1854, 
and  Kitt  in  1885  recognised  it  as  common,  and  proposed  for  it  the 
title  of  "  contagious  catarrhal  agalaxia."  It  also  occurs  in  Denmark, 
Italy,  and  England. 

Contagious  streptococcic  mammitis  of  cows  always  assumes  a  chronic 
form,  during  the  course  of  which  indurated  centres  appear,  varying  in 
size  between  that  of  a  hazel-nut  and  a  walnut. 

Causation.  The  cause  is  always  to  be  found  in  contagion,  the 
disease  being  due  to  a  streptococcus,  which  has  been  carefully  studied 
by  Noeard.  Its  transmission  from  a  diseased  to  a  healthy  udder  is  ex- 
plained by  the  fact  that  the  milkers  are  careless  as  to  cleanliness,  and 
thus  directly  convey  the  germs  to  healthy  teats  and  facilitate  infection. 

Symptoms.  As  in  chronic  mammitis,  general  symptoms  are  not 
well  marked,  though  some  cases  are  ushered  in  with  cough,  slight 
nasal  discharge,  and  offensive  diarrhoea.  The  first  appreciable  indi- 
cation is  a  change  in  the  milk,  which  diminishes  in  quantity,  and, 
although  normal  to  all  appearance,  coagulates  rapidly  if  left  undis- 
turbed. Infection  has  already  taken  place,  although  nothing  can  be 
detected  on  examining  the  udder. 

Next  appears  a  nodule  of  hardened  tissue  above  the  teat.  This 
nodule  is  of  rounded  or  ovoid  shape,  ill-defined  towards  its  periphery, 
and  it  becomes  progressively  enlarged  without  any  sign  of  acute 
inflammation.  The  milk  becomes  watery  and  of  a  bluish  colour. 
Microscopical  examination  reveals  numerous  streptococci.  The  harden- 
ing process  proceeds  slowly.  At  the  end  of  several  months  the 
sclerosis  may  only  have  extended  to  one-third  of  the  height  of  the 
infected  quarter.  With  the  appearance  of  these  lesions  the  character 
of  the  milk  again  changes.  It  becomes  yellowish  in  colour  and  foetid, 
and  contains  a  fibrous  reticulum,  whilst  its  reaction  is  distinctly 
acid.  The  lesions,  which  at  first  had  been  confined  to  one  quarter, 
successively  extend  to  the  others  unless  precautions  are  taken. 

Lesions.  The  lesions  consist  in  mammary  sclerosis,  with  nodules 
which  progressively  increase  in  size.  This  sclerosis  originates  in  the 
galactophorous  canals,  and  extends  first  to  the  periphery,  then  to  the 
interstitial  connective  tissue;  the  latter  undergoes  hyperplasia  and 
confines  within  its  tracts  the  true  glandular  elements,  destroying 
their  secretory  power.     Locally,  catarrhal  mammitis  exists. 


CHRONIC   MAMMITIS.  581 

The  lesions  can  easily  be  recognised  on  microscopic  examination, 
and,  when  the  section  is  suitably  stained,  numerous  streptococci  can 
be  detected  in  the  acini,  which  are  blocked  with  proliferating  epi- 
thelial cells.  These  lesions  are  due  to  the  invasion  of  colonies  of 
micro-organisms,  which  spread  from  below  upwards. 

The  streptococcus  causing  this  mammitis  colours  readily  with 
thionin  and  methylene  blue.  It  can  be  cultivated  in  liquid  and 
solid  media  containing  sugar  or  glycerine,  but  growth  is  impeded  by 
the  presence  of  peptone  or  common  salt.  Under  ordinary  circum- 
stances the  culture  dies  after  some  weeks,  but  if  the  acidity  of  the 
medium  is  neutralised  by  the  addition  of  powdered  carbonate  of 
lime,  it  preserves  its  vitality  for  six  or  eight  months.  The  culture 
when  injected  into  the  udder  of  a  healthy  cow  or  she-goat  reproduces 
the  disease.  The  micro-organism  is  not  pathogenic  for  any  of  the 
smaller  animals  used  for  purposes  of  experiment. 

Diagnosis  and  prognosis.  The  diagnosis  is  easy,  the  presence  of 
the  sclerotic  nodules  being  characteristic,  whilst  in  doubtful  cases  a 
microscopical  examination  can  always  be  made. 

The  treatment  should  be  prophylactic  and  curative. 

Prophylactic  treatment  comprises  disinfection  of  the  milkers'  hands, 
which  are  the  ordinary  vehicles  of  contagion,  and  disinfection  of  the 
cow's  udder.  Diseased  animals  in  a  byre  should  be  milked  last  of  all, 
and  the  milk  should  be  destroyed. 

Curative  treatment  is  confined  to  local  antiseptic  injections.  Warm 
concentrated  boric  solution  gives  good  results.  The  injections  may  be 
repeated  three  or  four  times  a  day  after  milking,  the  liquid  being  left 
for  a  certain  time  within  the  udder.  In  this  way  animals  suffering 
only  from  a  slight  attack  may  be  cured,  but  when  the  disease  is 
already  somewhat  advanced  injections  lose  their  effect. 

Injections  of  fluoride  of  sodium  ("l  to  '5  per  cent,  strength) 
appear  to  be  much  more  effectual.  Moussu  claims  to  have  cured  by 
this  means  several  old- standing  cases  where  all  four  quarters  of  the 
gland  were  diseased. 

These  injections  necessitate  the  same  precautions  as  those  above 
indicated  for  securing  perfect  asepsis.  In  grave  cases  it  is  very  diffi- 
cult to  prevent  the  disease  from  extending  in  infected  stables,  because 
the  necessary  precautions  cannot  be  observed. 

CHRONIC     MAMMITIS. 

Chronic  inflammation  of  the  udder  may  form  a  termination  of 
ordinary  acute  mammitis,  or  it  may  result  from  infection  with  or- 
ganisms of  a  less  virulent  type. 


582  DISEASES    OF    THE    MAMMARY    (JLANDS. 

In  cases  of  acute  mammitis,  where  severe  injury  of  the  mterstitial 
tissue  or  mammary  parenchyma  has  occurred,  its  physiological  func- 
tion is  partially  destroyed.  The  circulation  is  disturbed,  the  vessels 
undergo  change,  the  layers  of  connective  tissue  are  indurated  and 
sclerotic,  the  epithelial  tissue  is  not  fully  restored,  and  chronic 
inflammation  of  the  udder  persists. 

Clinically,  it  is  impossible  to  distinguish  all  the  variations  that 
may  occur,  because  the  constituent  tissues  are  all  injured,  and  the 
disease  is  of  a  mixed  type,  with  very  numerous  variations. 

Symptoms.  When  chronic  mammitis  follows  the  acute  form  its 
onset  is  only  indicated  by  gradual  diminution  in  the  signs  of  acute 
inflammation.  The  appetite  is  regained,  and  all  the  important  vital 
functions  are  properly  performed. 

Nevertheless,  it  is  possible  to  distinguish  two  different  clinical 
forms.  In  one,  the  secretion  of  milk  is  almost  entirely  suspended, 
the  udder  becomes  atrophied,  shrivelled  and  sclerotic  ;  the  hardening 
gradually  continues,  and  the  patients,  being  useless  as  milch  cows, 
can  only  be  fattened  for  slaughter.  The  induration  may  be  partial, 
nodular,  or  diffused. 

In  the  other  form  the  udder  is  large,  but  the  milk  is  replaced  by 
a  purulent  secretion  which  permeates  the  acini  and  galactophorous 
canals.  Although  they  eat  well,  the  patients  remain  thin,  and  are 
with  difficulty  fattened  for  slaughter. 

The  suppuration  may  be  diffuse  or  local.  In  rarer  cases  it  is 
localised  in  the  form  of  "cold  abscess." 

Treatment.  No  treatment  can  perfectly  restore  the  udder  after 
chronic  mammitis  with  sclerosis  and  atrophy. 

In  the  suppurating  forms  of  chronic  mammitis  the  morl)id  secre- 
tion may  be  checked  by  internal  irrigation  of  the  udder  and  antiseptic 
injections,  but,  as  this  treatment  necessitates  careful  and  continued 
attention,  it  is  usually  out  of  the  question. 

If  only  one  quarter  is  diseased  the  animal  may  be"  kept  for  milking 
purposes,  but  where  two  or  three  quarters  are  attacked  it  should  be 
prepared  for  the  butcher. 

In  cows  suffering  from  chronic  purulent  mammitis  of  all  four 
quarters,  Kroon  suggests  removing  the  teats  in  order  to  facilitate 
fattening.  The  teats  are  removed  with  the  bistouri  or  scissors,  by 
which  means  a  large  opening  into  the  galactophorous  sinus  is  pro- 
duced, through  which  the  purulent  secretion  escapes  freely  and 
continuously  ;  the  retention  of  pus  and  intoxication  in  consequence  of 
resorption  are  prevented  and  the  animal  can  be  fattened,  which  Avould 
be  difficult  without  the  operation, 


GANGRENOUS   MAMMITIS   OF   MILCH    EWES.  583 

GANGRENOUS     MAMMITIS     OF     MILCH     EWES. 

This  disease  occurs  in  different  parts  of  France,  and  has  also  been 
seen  in  Germany. 

Causation.  Lafosse  in  1856  attributed  it  to  the  dark  and  dirty 
condition  of  the  sheep-folds,  a  cause  which  certainly  contributes  to 
its  propagation,  though  it  is  not  the  determining  cause  of  the  disease 
itself.  The  latter  is  a  specific  micrococcus  discovered  in  1875  by 
Eivolta,  and  thoroughly  studied  by  Nocard  in  1886  and  1887. 

Symptoms.  The  course  of  the  symptoms  offers  a  certain  analogy 
to  that  of  septic  engorgements  and  interstitial  mammitis  or  mammary 
lymphangitis.  As  a  rule  only  one  gland  is  infected,  but  generally 
symptoms  at  once  appear,  indicating  an  extremely  dangerous  condition, 
viz.,  peracute  mammitis.  The  patient  suddenly  becomes  dull  and 
entirely  loses  appetite,  rumination  ceases  and  respiration  is  short 
and  jerky,  although  the  bodily  temperature  does  not  always  rise  to  any 
marked  extent. 

Local  symptoms  soon  develop.  The  udder  assumes  a  violet-red 
tint  and  becomes  the  seat  of  an  erysipelatous  swelling ;  the  local  tem- 
perature rises,  but  as  the  disease  progresses  it  gradually  falls  again. 
Milk  secretion  ceases. 

All  these  appearances  rapidly  become  aggravated.  The  patient  lies 
down  ;  the  cedematous  swelling  extends  to  the  belly  and  even  to  the 
chest  and  thighs ;  the  local  temperature  falls,  indicating  the  immi- 
nence of  gangrene ;  the  teat  becomes  contracted,  and  the  pulse  is  very 
frequent  and  almost  imperceptible.  From  time  to  time  the  animal 
grinds  its  teeth. 

The  bodily  temperature  next  falls  to  98""  or  even  96  °Fahr.  (37°  or 
36°  C),  and  the  animal  shows  extreme  prostration.  The  subcutaneous 
swelling  extends  as  far  as  the  sternum  in  one  direction  and  the 
quarters  and  perineum  in  the  other.  The  udder  crackles  under  the 
finger.     Death  occurs  without  a  struggle. 

All  these  symptoms  follow  as  a  rule  in  barely  more  than  twenty- 
four  hours.  Nevertheless,  in  certain  cases,  the  disease  lasts  for  three, 
four  or  five  days.  Cases  of  spontaneous  recovery  are  exceptionak 
The  gangrenous  part  may  become  delimited  and  slough  away,  leaving 
an  enormous  suppurating  wound,  which  slowly  cicatrises.  Even 
though  the  animals  survive,  they  never  recover  condition,  but  remain 
weakly,  so  that,  from  a  monetary  standpoint,  death  would  have  been 
preferable.  Moreover,  the  lambs  are  starved  and  require  a  foster- 
mother. 

Lesions.  Post-mortem  examination  reveals  cedematous  infiltration 
of  the  udder   and  surrounding  connective  tissue,  and  often  extensive, 


584  DISEASES   OF    THE    MAMMARY   GLANDS. 

diffuse  gangrene.  The  serosity  is  of  a  reddisli  colour,  and  sections 
of  the  diseased  udder  of  a  violet  tint.  The  tissues  of  the  udder  and 
the  serous  liquid  contain  the  specific  micrococcus. 

It  is  very  small,  and  stains  readily  b}^  the  Gram-Nicolle  method. 
It  grows  rapidly  in  liquid  and  solid  media,  liquefies  gelatine,  and 
quickly  renders  neutral  media  alkaline. 

The  injection  of  a  few  drops  of  culture  into  the  udder  of  a  milch 
ewe  reproduces  the  typical  disease.  In  any  other  species  it  is  with- 
out effect.  Infection  occurs  through  the  open  extremity  of  the  teat, 
or  the  medium  of  a  wound,  and  the  micro-organism  is  so  virulent 
that  it  rapidly  invades  all  the  tissues. 

Treatment.  No  antiseptic  treatment  appears  capable  of  checking 
the  course  of  the  disease. 

Surgical  treatment  alone  is  of  any  value,  and  consists  in  ablation 
of  the  udder,  followed  by  antisej^tic  dressing.  Only  a  portion  of  the 
gland  is  removed  :  an  elliptical  incision  is  made,  including  the  diseased 
teat,  the  skin  is  then  dissected  free  so  as  to  form  a  flap  ;  the  diseased 
tissue  is  isolated ;  last  of  all,  the  vessels  are  ligatured.  The  conse- 
quences of  operation  are  less  grave  than  might  be  expected,  consider- 
ing the  size  of  the  wound,  which  heals  with  fair  rapidity. 

Moussu  has  frequently  practised  this  radical  method  of  treatment 
without  losing  a  single  case.  The  remaining  portion  of  the  udder 
becomes  hypertrophied,  and  is  often  quite  capable  of  secreting  suffi- 
cient milk  for  the  nourishment  of  one  lamb. 

GANGKENOUS    MAMMITIS    IN    GOATS. 

Goats  suffer  from  a  form  of  mammitis  which  presents  symptoms 
precisely  similar  as  regards  development  and  termination  to  that 
of  ewes.  The  disease  occurs  in  a  sporadic  form  in  animals  giving 
milk,  whatever  their  breed  or  the  conditions  under  which  they  are 
kept.     It  has  been  seen  at  Alfort,  as  well  as  at  Lyons. 

Moussu  has  seen  it  in  an  enzootic  form  in  herds  of  milch  goats 
near  Bizerta  (Tunis),  and  considers  that  contagion  results  from  kids 
sucking  healthy  animals  after  having  been  suckled  by  diseased  ones. 
Fifty  milch  goats  out  of  a  total  of  three  hundred  were  affected  at 
the  time  of  Moussu's  visit,  and  two  had  already  succumbed. 

The   diagnosis  presents  no  difficulty. 

The   prognosis  is  very  grave. 

The  treatment  is  precisely  similar  to  that  of  gangrenous  mammitis 
of  milch  ewes,  viz.,  ablation  of  the  diseased  udder. 

Of  the  above-mentioned  herd,  twenty  animals  were  operated  on, 
and  all  recovered  without  accident.     Among  the  others  treated  by  less 


TUMOURS  OF  THE  UDDER.  585 

radical  methods,  such  as  scarifications,  incisions,  antiseptic  injections, 
etc.,  eight  died.     The  only  justifiable  treatment,  therefore,  is  ablation. 

CYSTS    OF    THE    UDDER. 

Cysts  of  the  udder  may  assume  one  of  two  forms,  milk  or  galactoce- 
lous  cysts  and  serous  cysts;  possibly  the  latter  are  only  hydatid  cysts. 

Both  varieties  are  of  the  nature  of  retention  cysts,  and  result  from 
accidental  obliteration  of  a  milk  conduit,  which  has  been  obstructed 
by  coagulated  casein,  or  from  atresia  due  to  contraction  of  inflamed 
connective  tissue.  The  acini  are  isolated  and  become  dilated,  the  milk 
undergoes  changes  in  composition,  the  secretory  epithelium  degenerates, 
and  the  cyst  is  produced. 

The  serous  or  milk  cysts  may  vary  considerably  in  size,  and  always 
show  a  rapid  tendency  to  suppuration. 

The  diagnosis  is  based  on  the  detection  of  uniform  fluctuation 
without  excessive  sensibility,  and  can  be  confirmed  by  an  exploratory 
capillary  puncture. 

The  prognosis  is  grave,  for  recovery  can  only  occur  after  the  lining 
membrane  of  the  cyst  has  been  destroyed. 

Treatment.  Puncture  followed  by  irrigation  is  insufficient,  whatever 
the  nature  of  the  cyst. 

Free  incision,  or  simple  puncture  with  a  bistoury,  produces  sup- 
puration within  the  cystic  cavity,  which  continues  until  the  lining 
membrane  is  completely  destroyed ;  but  this  takes  a  very  long  time. 

Eemoval  of  the  entire  cyst,  either  with  the  bistoury  or  by  tearing 
through  the  surrounding  connective  tissue,  is  the  best  method  of  treat- 
ment. The  wound  thus  produced  heals  regularly  and  rapidly  under  an 
antiseptic  surgical  dressing. 

TUMOURS    OF    THE    UDDER. 

Tumours  of  the  udder  have  been  little  studied  in  the  larger 
domestic  animals,  the  reason  being  that  immediately  animals  cease  to 
yield  milk  they  are  fattened  and  despatched  to  the  butcher.  Clinically, 
therefore,  these  tumours  are  not  of  great  practical  importance. 

Without  entering  into  general  considerations  of  a  pathological 
anatomical  character,  by  which  different  varieties  of  these  tumours  are 
differentiated,  we  may  say  that  they  assume  one  of  three  different 
forms.  The  first  is  sharply  circumscribed,  of  clearly  defined  shape,  and 
easily  separated  from  neighbouring  tissues,  to  which  it  adheres  but 
slightly.  Such  tumours  are  benign,  and  have  no  tendency  to  return 
after   removal. 

The  second  is  ill-defined,  very  adherent,  and  appears  to  infiltrate 


586  DISEASES   OF   THE   MAMMARY   GLANDS. 

the  siuTounding  tissue.  It  is  malignant  in  character,  is  often  impossihle 
to  completely  remove,  returns  after  extirpation,  and  infects  neighbouring 
lymphatic  glands. 

Between  these  two  varieties  may  be  placed  a  third,  occupying  an 
intermediate  position  as  regards  both  its  characteristics  and  gravity. 

Practically  a  knowledge  of  the  above  facts  is  a  sufficient  guide  in 
dealing  with  lesions  of  this  character. 

Canalicular  Papillomata. — There  exists  another  variety  of  tumours 
which  is  of  much  more  frequent  occurrence,  and  which  is  apt  to  cause 
mistakes.     This  variety  consists  of  inter-canalicular  papillomata. 

These  show  no  sign  of  their  existence  on  external  examination  of 
the  diseased  udder,  and  can  be  diagnosed  only  by  reasoning  based  on 
the  signs  observed. 

They  are  of  very  small  size,  and  grow  from  the  internal  wall  of 
the  galactophorous  sinus  or  excretory  canal.  They  increase  in  length, 
finally  extending  for  some  distance  along  the  sinus,  where  they  remain 
unrecognised  until  some  external  manifestation  arouses  suspicion  as  to 
their  existence. 

Under  the  mechanical  contraction  due  to  milking  they  easily  become 
excoriated,  and  their  existence  is  then  suggested  almost  solely  by  the 
fact  that  the  milk  is  tinted  with  blood,  for  palpation  of  the  udder  very 
seldom  gives  more  than  negative  results. 

The  diagnosis  is  always  doubtful.  The  prognosis  is  grave,  because 
it  is  impossible  to  remove  the  tumour,  which  is  often  deeply  placed 
within  the  udder.     There  is  no  curative   treatment. 


VERRUCOUS    PAPILLOMATA     OF    THE    UDDER. 

In  cows  suffering  from  cutaneous  papillomata  the  udder  is  often 
covered  with  a  varying  number  of  little  sessile  warts,  which  are  spread 
over  a  considerable  surface,  are  very  sensitive,  and  bleed  at  the  lightest 
touch.  Milking  is  thus  rendered  extremely  painful  and  difficult ;  the 
animals  struggle,  kick,  and  become  dangerous. 

The  condition  is  extremely  troublesome,  and  in  spite  of  every  pre- 
caution the  milk  is  always  soiled. 

The  best  method  of  treatment  consists  in  removing  the  warts 
individually  with  fine,   sharp-bladed  curved  scissors. 

The  animals  must  be  firmly  secured,  if  necessary  cast,  and  the 
operator  should  avoid  removing  more  of  the  skin  covering  the  udder 
than  is  absolutely  necessary.  The  bleeding  which  follows  is  trifling, 
and  stops  of  itself.  After  washing  the  parts  with  an  antiseptic  solu- 
tion, the  little  wounds  may  be  powered  with  a  mixture  in  equal 
proportions  of  tannin  and  boric  acid. 


CHAPTER    VI. 

DISTURBANCE    IN    THE    MILK    SECRETION    AND 
CHANGES    IN    THE    MILK. 

Changes  in  the  milk  are  so  common  and  play  so  important  a  part 
in  the  milk  industry  that  it  is  absolutely  necessary  to  mention  the 
more  important,  the  country  veterinary  surgeon  being  frequently  con- 
sulted on  this  point. 

The  udder  acts  as  a  natural  emunctory,  just  like  the  kidney,  by 
which  are  eliminated,  in  consequence  of  special  selective  properties, 
certain  natural  ptinciples  (the  active  principles  contained  in  the  forage 
and  other  food,  vegetable  alkaloids,  etc.),  drugs  (alcohol),  and  poisons 
(nicotine).  This  physiological  peculiarity  explains  the  influence  of 
changes  of  diet  on  the  composition  of  the  milk  in  mothers  and  on 
the  condition  of  their  offspring.  In  the  human  species  it  also  explains 
congenital  alcoholism  in  children,  and  a  number  of  diseases  whose 
cause  was  formerly  unknown. 

Agalaxia. — This  term  implies  a  temporary  or  definite  arrest  of 
the  milk  secretion.  In  many  instances  it  represents  nothing  more 
than  a  disturbance  in  the  physiological  function  of  the  gland,  but  in 
others  it  forms  a  true  diseased  condition. 

Thus  it  is  beyond  dispute  that  psychical  influences  may  produce 
disturbance  in  this  respect.  Temporary  suspension  in  the  secretion  as 
a  consequence  of  removal  of  the  offspring  from  its  mother,  especially 
when  the  young  animal  has  been  sucking  for  several  days  or  weeks, 
is  a  fact  very  well  known  to  all  breeders. 

Under  ordinary  circumstances,  however,  the  reasons  are  quite 
different,  and  when  the  secretion  of  milk  is  diminished  or  suppressed 
it  is  due  to  the  ingestion  of  plants,  substances,  or  drugs  which  check 
the  secretion  of  milk.  All  the  solanacefe  (belladonna,  hyoscyamus, 
stramonium,  woody  nightshade,  etc.),  certain  umbelliferae  (hemlock), 
colchicum,   etc.,    have   this  effect. 

As  to  agalaxia  of  a  true  pathological  character,  it  occurs  in  debili- 
tating and  grave  diseases,  and  sometimes  follows  certain  contagious 
forms  of  mammitis  complicated  with  sclerosis  of  the  udder  (infectious 
agalaxia  of  goats). 


588      DISTURBANCE   IN  THE  MILK   SECRETION  AND  CHANGES  IN  THE  MILK. 

Diagnosis.     The  diagnosis  of  agalaxia  presents  no  difficulty. 

Prognosis.  Tlie  prognosis  varies,  according  to  the  determining 
cause.  In  cases  of  accident  and  in  temporary  agalaxia,  it  is  sufficient 
to  change  the  food  in  order  to  restore  the  secretion.  Cooked  food 
and  warm  drinks,  with  an  allowance  of  roots  such  as  turnips  or  man- 
golds, have  excellent  results.  Where  restoration  of  the  secretion  is 
delayed  the  use  of  what  are  called  galactogogues  has  been  recommended, 
comprising  fennel,  carraway,  cummin,  aniseed,  juniper,  sulphur,  etc., 
mixed  in  equal  parts  and  given  in  doses  of  6  to  8  drachms  per  day  for 
a  cow. 

They  act  principally  through  the  stimulating  effects  of  their  aromatic 
principles. 

MICROBIC    CHANGES    IN    MILK. 

LACTIC    FERMENTS. 

Microbic  changes  in  milk  are  much  commoner  than  changes  of  a 
chemical  nature.  Milch  animals  differ  very  markedly  one  from  another, 
and,  according  to  circumstances,  give  milk  of  ordinary  composition, 
milk  of  a  very  rich  character,  or  watery  milk ;  but  the  most  important 
changes  in  composition  are  those  due  to  microbic  agents. 

During  the  milking,  and  according  to  whether  this  is  performed  in  a 
low,  dirty  byre,  in  a  clean,  roomy  byre,  or  in  the  open  air,  various 
numbers  of  germs  obtain  entrance  to  the  milking  vessels,  and  develop 
there  with  extraordinary  rapidity.  The  milk  may  even  become  infected 
by  non-pathogenic  germs  while  still  within  the  udder,  in  the  sinus  and 
galactophorous  canals.  The  cleanliness  of  the  milking  vessels  also  has 
a  considerable  influence  on  the  number  and  variety  of  the  microbes 
which  may  eventually  germinate  in  the  liquid. 

Among  the  micro-organisms  usually  found  in  milk  there  are  some, 
however,  which  always  preponderate  and  play  the  part  of  organised 
ferments,  viz.,  the  lactic  ferments  and  the  organisms  which  cause  co- 
agulation of  the  casein  ;  these  may  be  regarded  as  normal  constituents. 
The  others  are  more  or  less  foreign,  and  may  cause  important  changes 
in  the  milk  or  cream. 

The  lactic  ferments  are  numerous,  comprising  the  lactic  bacilli  of 
Hueppe  and  Grotenfeld,  the  micrococci  of  Hueppe  and  Marpmann,  and 
the  bacilli  and  micrococci  of  Freudenreich.  These  different  agents  act 
on  the  lactose  of  the  milk,  decomposing  it  into  carbonic  and  lactic 
acids,  which  coagulate  the  milk. 

Another  group  of  micro-organisms  which  were  well  studied  by 
Duclaux  comprises  those  acting  on  the  casein,  among  others  Ti/rothrix 
tenuis,  fiUformis,  turgidus,  scabcr,  rirgula,  etc. 

These  organisms  secrete  principles  having  similar  effects  to  those  of 


MICROBIC   CHANGES   IN   MILK.  589 

rennet,  and  are  capable  of  coagulating  enormous  quantities  of  milk. 
After  a  certain  time,  they  also  secrete  a  second  diastase,  viz.,  casease, 
which  acts  in  the  ripening  of  cheese. 

Clotted  Milk. — This  term  is  used  in  dairies  to  indicate  milk  which 
coagulates  in  lumps  immediately  after  being  withdrawn  from  the  udder, 
or  which  coagulates  spontaneously  a  few  hours  later. 

The  change  may  be  of  a  chemical  nature,  depending  on  conditions 
of  keep  or  feeding.  More  frequently,  however,  it  is  related  to  a  latent 
non-pathogenic  infection  of  the  udder,  or  to  immediate  infection  of  the 
milk  after  removal  by  lactic  ferments  contained  in  the  milk  vessels  or 
the  atmosphere. 

It  is  necessary,  according  to  circumstances,  either  to  modify  the  diet 
or  disinfect  the  milk  vessels,  and  immediately  pasteurise  the  milk. 

Milk  without  Butter. — Less  commonly  the  diseased  condition  is 
indicated  by  marked  diminution  in  the  quantity,  of  cream. 

Churning  only  produces  a  poor  kind  of  butter,  particles  of  which  do 
not  readily  cohere.  This  peculiarity  is  due  to  the  presence  of  micro- 
organisms, which  have  not  yet  been  fully  identified.  It  can  be  prevented 
by  disinfection  of  the  milking  vessels,  as  well  as  of  the  dairy  itself,  and 
by  the  use  of  centrifugal  separators. 

Putrid  Milk. — This  milk  is  characterised  by  its  odour.  It  cannot  be 
used  for  making  butter.  In  fact,  as  soon  as  the  cream  separates,  little 
bubbles  of  gas  form  at  various  points  and  break,  leaving  small  cavities. 
These  little  separate  cavities  reunite  very  rapidly,  and  the  cream  becomes 
reabsorbed  as  fast  as  it  is  formed.  Afterwards  oily  drops  formed  of 
butyric,  capric,  and  caprylic  acids  appear  in  the  depressions  and  give 
the  milk  a  repulsive  odour  (rancidity). 

This  change  is  seen  during  mammitis,  but  most  commonly  results 
from  uncleanliness  in  byres  and  dairies.  In  the  latter  case  putrefaction 
occurs  about  twenty-four  hours  after  milking,  and  is  due  to  the  growth 
in  the  milk  of  Bacterium  termo,  lineola,  etc.  These  organisms  are  pre- 
sent in  the  dust  which  falls  into  the  milking  pails  in  the  byre  ;  when 
milk  so  contaminated  is  stored  in  the  dairy  the  changes  occur. 

Putrid  odour  may  also  be  due  to  the  presence  of  ammoniacal  gas 
in  the  byre,  or  to  special  toxins  liberated  by  microbes  which  have  found 
their  way  into  the  milk.  It  is  most  marked  during  the  warm  seasons  of 
the  year. 

The  occurrence  of  putrid  milk  can  be  prevented  by  disinfecting  the 
dairy  and  the  milking  pails  daily  for  a  certain  time. 

Mucous,  viscous,  or  thready  Milk. — These  terms  are  applied  to  a 
condition  which  usually  appears  twenty-four  or  thirty-six  hours  after  the 
milk  has  been  withdrawn.  The  milk  seems  thick  and  viscous,  and  can 
be  drawn  out  into  threads  like  mucus.    It  sticks  to  neighbouring  objects, 


590      DISTURBANCE  IN   THE  MILR   SECRETION   AND  CHANGES   IN  THE  MlLIv. 

and  adheres  to  milk  vessels  like  molasses.  It  coagulates  imperfectly' 
on  standing,  gives  little  cream,  and  even  this  cream  onl}'  furnishes  a 
mawkish,  ill-flavoured  butter. 

In  certain  parts  of  Switzerland  the  production  of  mucous  milk  is 
favoured,  because  it  is  employed  in  making  cheeses. 

The  change  is  due  to  the  presence  of  various  micro-organisms. 
Those  which  have  been  best  studied  are  Schmidt-Miilheim's  micrococci, 
the  Acti)iuhacter  polymorphns  of  Duclaux,  the  Bacillus  lactis  intidtosi  of 
Loffler,  the  Bacillus  lactis  of  Adametz,  the  Streptococcus  hollandicus,  and, 
finally,  three  others  which  are  much  commoner,  Guillebeau's  bacillus, 
the  Micrococcus  Freudenreichii,  and  the  Bacterium  Hessii.  These  micro- 
organisms act  on  the  lactose,  decomposing  it  and  causing  the  formation 
of  a  kind  of  filamentous  mucilage,  which  can  be  isolated  by  the  addition 
of  alcohol. 

The  mucilaginous  change  in  milk  can  be  prevented  by  ordinary 
methods  of  disinfection. 

Red  Milk. — Milk  which  becomes  red  some  hours  after  withdrawal,  or 
within  forty-eight  hours  after  milking,  should  be  distinguished  from 
milk  which  on  withdrawal  from  the  udder  is  tinted  red  in  consequence 
of  hfemorrhage  within  the  udder  itself.  When  the  milk  is  of  a  hemor- 
rhagic tint  the  blood  corpuscles  are  soon  deposited  on  the  bottom  of  the 
vessel  if  the  milk  is  allowed  to  remain  undisturbed. 

The  tint  which  the  milk  assumes  is  due  to  the  growth  of  chromogenic 
organisms,  the  best  knoAvn  of  which  are  as  follows : — 1.  B.  proiUf/iosus, 
which  produces  large  red  patches  on  the  surface.  It  grows  readily  on 
potato  and  gelatine,  which  it  liquefies.  2.  The  Sarcina  rosea,  which 
develojDS  first  of  all  in  the  cream  and  afterwards  invades  the  milk.  It 
grows  in  sterilised  milk,  on  alkaline  potato,  and  on  gelatine.  3.  The 
Bacterium  lactis  erythrogenes,  which  liquefies  gelatine  and  produces  a 
reddish  coloration.  Casein  can  be  precipitated  and  peptonised  by  means 
of  its  cultures.  It  develops  in  the  milk  below  the  cream,  the  serum 
alone  becoming  red,  and  only  when  shaded  from  the  light. 

Blue  Milk. — In  this  case  the  milk  appears  normal  when  withdrawn, 
but  some  days  afterwards  shows  blue  patches,  which  gradually  increase 
in  size,  and  by  uniting  produce  a  distinct  blue  tint  at  the  surface. 

This  change  is  connected  with  the  presence  of  the  B.  cyanoejenus. 
The  organism  grows  in  sterilised  milk,  but  in  this  case  merely  produces 
greyish  patches,  the  blue  tint  only  occurring  when  a  certain  quantity  of 
lactic  acid  is  added  or  when  the  ordinary  lactic  ferments  are  present. 

Yellow  Milk. — A  yellow  tint  occurs  in  ordinary  milk  and  cream, 
l)articularly  in  certain  breeding  districts — in  Normandy,  for  example, 
where  the  butter  produced  is  greatly  valued  on  account  of  this  ap- 
pearance.     Pathological   yellow  milk    is   the   result   of   the   growth   of 


MlCROBIC   CHANGES   IN    MILK.  591 

B.  synxantkus  Scliroter,  which  secretes  a  substance  resembhng  rennet, 
curdles  the  milk,  and  finally  dissolves  the  clot,  at  the  same  time 
producing  the  yellow  colour. 

Bitter  Milk. — Milk  which  is  of  a  normal  character  on  being  with- 
drawn from  the  udder  may  acquire  a  bitter  taste  some  hours  later.  At 
rest,  this  milk  produces  a  small  quantity  of  yellowish,  frothy  cream. 
The  organisms  which  produce  the  change  have  been  studied  in  Ger- 
many, Switzerland,  and  Auvergne.  We  may  mention  Weizmann's 
bacillus  of  bitter  milk,  Conn's  micrococcus  of  bitter  milk,  and  Duclaux's 
Tyrothrix  (lenicnlatus. 

Medicated  Milk. — Medicated  milk  may  be  divided  into  two  kinds : 
Firstly,  medicated  milk  proper,  which  differs  from  normal  milk  inas- 
much as  it  contains  a  certain  proportion  of  drugs,  which,  when  swallowed 
by  milch  cows  are  partly  eliminated  through  the  udder.  When  taken 
by  a  young  animal  or  child  such  milk  has  a  distinct  therapeutic  effect, 
depending  on  the  principles  employed. 

It  does  not  appear,  however,  that  up  to  the  present  any  very  great 
success  has  followed  this  system.  It  is  possible  to  increase  the  richness 
of  the  milk  in  phosphates,  but  as  regards  mercurial  or  iodine  prepara- 
tions the  failure  has  been  complete. 

Secondly,  fermented  milks,  which  in  addition  to  their  nutritive  action 
are  made  more  digestible. 

Fermented  milk  is  easily  digested,  and  is  better  borne  by  the  weakest 
stomachs. 

In  human  practice  the  fermented  forms  of  milk  are  two,  viz.,  kephyr 
and  koumiss. 

Kephyr  is  prepared  in  Afghanistan  and  Persia  from  camel's  milk, 
but  for  some  years  past  it  has  been  made  in  England  with  cow's  milk, 
A  certain  quantity  of  cow's  milk  is  placed  in  a  bottle  and  the  ferment, 
consisting  of  kephyr  grains,  is  added.  The  lactose  is  converted  into 
carbonic  acid  and  alcohol  in  consequence  of  the  action  of  certain  lactic 
microbes. 

This  milk  after  ingestion  does  not  require  to  be  coagulated  and  then 
digested  before  absorption,  a  fact  which  considerably  diminishes  peptic 
digestion. 

Koumiss  is  a  milk  preparation  resembling  kephyr;  it  is  made  by 
the  Kirghizes  with  mare's  milk  according  to  the  same  principles,  but 
the  ferment  employed  gives  more  alcohol. 

Preservation  of  Milk. — On  account  of  the  importance  of  preserving 
milk  for  use  in  large  towns,  in  hospitals,  and  in  the  army  during  war, 
the  question  of  its  preservation  has  long  been  studied. 

Chemical  Processes. — The  principle  of  preserving  milk  by  chemical 
action  consists  in  preventing,  or  at  least  retarding,  the  changes  which 


592      DISTURBANCE  IN  THE   MILK  SECRETION  AND  CHANGES  IN   THE  MILK. 

inevitably  follow  exposure  to  the  air.  For  this  purpose,  chemical  sub- 
stitutes are  added  which  in  themselves  have  no  injurious  action.  Those 
most  commonly  employed  are  : — 

Carbonate  of  soda  .  .  . .  .  .  .  .  .  .     45  grs.  per  quart. 

Bicarbonate  of  soda        .  .  . .  .  .  .  .     45  grs.  ,, 

Boric  acid  .  .  . .  .  .  .  .  .  .  .  .       15  to  30  grs.  ,, 

Salicylic  acid        . .  . .  . .  . .  .  .  .  .     12  grs.  „ 

Borax         60  grs.  ,, 

Lime  20  grs.  ,, 

The  results  obtained  are  of  comparatively  little  value  ;  the  milk  only 
keeps  for  a  few  hours,  or  at  the  most  for  three  or  four  days. 

Cold. — Kefrigeration,  which  is  so  valual)le  in  preserving  all  kinds  of 
animal  products  for  long  periods,  has  also  been  used  for  preserving 
milk.  Unfortunately,  although  cold  impedes  the  development  of  bacteria, 
it  also  has  the  grave  inconvenience  of  causing  the  cream  to  separate 
from  the  milk,  and  it  being  impossible  to  mix  them  again  satisfactorily, 
milk  preserved  in  this  way  is  more  or   less  unfit  for  consumption. 

Heat. — The  principle  of  preserving  milk  by  heat  is  based  on  the 
destruction  of  the  micro-organisms  at  a  high  temperature.  In  this 
respect  again,  one  meets  with  obstacles,  for,  if  the  heat  be  applied 
direct,  some  of  the  principles  of  the  milk  are  converted  into  caramel, 
and  if  the  temperature  rises  beyond  157'^  Fahr.  (70*^  C.)  the  com- 
position of  the  milk  is  changed. 

Preservation  hy  Oxygen. — Within  the  last  few  years  the  use  of  oxygen 
at  a  pressure  of  about  two  atmospheres  has  been  recommended. 
When  the  milk  is  to  be  used  it  is  only  necessary  slightly  to  relieve  the 
pressure  and  allow  the  oxygen  to  escape,  the  liquor  which  remains 
having  all  the  characters  and  qualities  of  fresh  milk.  The  method 
appears  excellent,  but  is  too  costly  for  every- day  use. 

Pasteurisation. — The  pasteurisation  of  milk  aims  at  destroying  the 
greater  proportion  of  the  ferments  above  mentioned.  The  milk  is 
heated  at  atmospheric  pressure,  and  is  kept  for  a  time  at  a  tempera- 
ture of  between  150^  and  157^  Fahr.  (65^  and  70'^  C).  It  preserves 
its  properties  and  composition,  but  sterilisation  is  not  complete,  and 
the  milk  cannot  be  kept  indefinitely. 

Concentrated  Milk. — Concentrated  milk  is  obtained  by  prolonged 
heating  to  157'^  Fahr.  (70°  C.)  in  a  vacuum,  when  it  becomes  syrupy 
by  evaporation  and  its  composition  is  not  greatly  modified.  It  is 
then  drawn  off  into  bottles,  which  are  hermetically  sealed  and  sub- 
jected to  a  higher  temperature  to  complete  the  destruction  of  all  the 
germs.  Condensed  milk  keeps  for  a  very  long  time.  To  prepare  it 
for  use  it  is  mixed  with  a  certain  quantity  of  water,  and  then  yields 
a  liquid  similar  to  normal  milk. 


MICROBIO   CHANGES   IN   MILK.  593 

Sterilisation. — Sterilisation  necessitates  the  use  of  special  apparatus 
in  which  the  milk  is  heated  in  a  water  or  steam  bath  sheltered  from 
the  action  of  the  air,  the  temperature  rising  to  212°  to  240°  Fahr. 
(100°  to  115°  C.)  ;  all  the  ferments  are  destroyed,  and  the  milk  will 
keep  indefinitely,  but  its  composition  is  slightly  modified. 

Diseases  Transmissible  to  Man  through  the  Medium  of  Milk.— 
Tuberculosis. — The  history  of  tuberculosis  contains  numerous  facts 
proving  the  possibility  of  contagion  by  milk  from  cows  suffering  from 
tuberculous  mammitis,  though  it  seems  necessary  that  the  milk 
should  be  taken  for  a  certain  time  to  produce  these  effects. 

Foot-aud-Moutli  Disease. — Observations  recorded  by  veterinary 
surgeons  prove  that  this  disease  affects  the  teats.  It  may  be  trans- 
mitted to  man.  The  milker  may  be  directly  inoculated,  but  the  milk 
is  the  ordinary  vehicle  of  contagion.  Ohauveau  saw  an  epidemic  in 
a  school  at  Lyons  where  milk  ^vas  obtained  from  cows  suffering  from 
foot-and-mouth  disease.  In  a  similar  w^ay  205  persons  were  inocu- 
lated at  Dover  in  1884,  and  suffered  from  vesicles  about  the  mouth. 

Although  foot-and-mouth  disease  is  extremely  benign  in  men,  it 
is  well  to  take  every  precaution  against  it. 

Gastro-hitestinal  Infections. — Cases  have  been  recorded  of  gastro- 
intestinal infection  in  young  animals  and  children  in  consequence  of 
consuming  milk  which  had  undergone  abnormal  changes.  Milk  con- 
taining various  kinds  of  micro-organisms  may  at  first  produce  lactic 
indigestion  and  afterwards  diarrhceic  enteritis. 


D.c.  Q  Q 


CHAPTER    VII. 
MALE    GENITAL    ORGANS. 

The  scrotum,  the  vaginal  sheath,  the  testicles,  the  vas  deferens, 
the  vesiculpe  seminales,  the  prostate,  and  Cowper's  glands  may  all 
become  the  seat  of  disease. 

The  scrotum  and  testicles  seldom  reveal  more  than  mechanical 
injuries  of  external  origin,  producing  wounds  and  cuts  and,  in  the 
case  of  severe  contusions,  haematoma  of  the  scrotum,  of  the  vaginal 
sheath,  and  of  the  testicles.  Inflammation  of  the  testicle,  that  is  to 
say,  traumatic  orchitis,  is  rare ;  on  the  other  hand,  Moussu  has  several 
times  seen  tuberculous  orchitis,  for  which  he  has  operated.  This, 
however,  was  in  the  boar.  These  different  lesions,  the  last  named 
excepted,  usually  heal  with  rest  and  the  application  of  antiseptic 
dressings,  anodyne  and  resolvent  lotions. 

Breeders  seldom  retain  more  entire  animals  than  are  strictly  neces- 
sary for  reproduction.  The  others  are  castrated,  and  this  alone 
explains  why  the  treatment  of  genital  diseases  in  male  animals  of 
any  species  is  rare. 

TUMOURS    OF    THE    TESTICLE. 

Of  the  genital  diseases  which  possess  real  clinical  interest  the 
most  important  are  tumours  of  the  testicle.  These  occur  not  only  in 
male  animals,  but  also  in  those  which  have  undergone  the  operation 
of  bistournage. 

It  might  a  priori  be  believed  that  in  an  animal  of  the  latter  class 
the  testicle  had  been  completely  destroyed,  not  only  from  the  physical, 
but  from  the  pathological  jDoint  of  view.  This,  however,  is  by  no  means 
the  case,  and  Cruzel  has  described,  under  the  erroneous  designation 
of  sarcocele,  tumours  of  the  testicle  which  develop  in  oxen  of  various 


Moussu  has  had  a  similar  experience  with  animals  of  from  four 
to  six  years  of  age  which  had  been  carefully  operated  on. 

These  tumours,  the  origin  of  which  is  unknown,  develop  at  the 
expense    of   the   rudiments   of   the   atrophied   testicle.      They   vary   in 


TUMOURS    OF   THE    TESTICLE. 


595 


character,  and  Moussu  has  only  observed  tumours  of  a  type  different 
from  that  of  the  testicle  itself,  containing  tracts  of  carcinomatous, 
sarcomatous,  and  fibrous  tissue.  They  also  appear  to  vary  greatly  in 
gravity,  for,  although  the  cases  seen  by  Moussu  had  become  generalised 
in  a  few  months,  Cruzel  states  that  these  tumours  may  remain  stationary 
for  several  years. 

The   symptoms   consist  in    progressive  enlargement  of  the  scrotal 
region  and  the  appearance  of 
a  tumour  surrounded  by  oede- 
matous  or  lardaceous  tissue. 

The  tumour,  which  is  con- 
fined to  one  side,  increases  in 
size,  is  bosselated  and  adherent 
at  points  to  the  surface  of  the 
skin,  while  it  is  insensitive  or 
only  slightly  painful  to  the 
touch. 

In  a  few  months  it  may  in- 
crease to  the  size  of  a  child's 
head.  The  animals  have  diffi- 
culty in  moving  or  lying  down, 
the  hind  limb  on  the  affected 
side  is  abducted,  and  the 
animal  usually  lies  on  its 
chest  and  abdomen.  The 
patient  rapidly  loses  flesh, 
although  the  appetite  remains 
good. 

"When  the  growth  is  re- 
moved, it  is  easy  to  prove 
that  the  tumour  has  developed 
in  the  atrophied  mass  of  tes- 
ticular tissue,  and  that  it  re- 
mains suspended  from  the  end 
of  the  cord. 

The    diagnosis    of   tumour 
of  the  testicle  is  extremely  easy,  for  the  condition  cannot  be  mistaken 
for  a  hgematoma  or  for  a  scrotal  abscess. 

The  prognosis  necessarily  depends  on  the  nature  of  the  tumour, 
but  as  it  is  impossible  to  determine  this  point  before  extirpation,  the 
prognosis  should  always  be  regarded  as  ver}^  grave. 

Treatment.  Whatever  the  nature  of  the  tumour,  ablation  is  ad- 
visable.    If  it  is  of  a  benign  character,  recovery  may  be  complete  and 

QQ  2 


Fig.  239.— Upper  surface  of  the  neck  of  the 
bladder  and  origin  of  the  urethra  in  the 
ox.  1,  Bladder;  2,  vesiculse  seminales ; 
3,  vas  deferens  ;  4,  principal  portion  of 
the  prostate  gland  extending  beneath  the 
sphincter  ;  5,  sphincter ;  6,  aponeurosis  of 
the  sphincter,  clothing  the  upper  portion 
of  the  urethra  and  the  flattened  portion  of 
the  prostate.     (After  Barrier.) 


596 


MALE   GENITAL   ORGANS. 


permanent,  but  if  it  is  malignant,  generalisation   will   rapidly  ensue. 

Before   interfering  surgically,  however,  it  is  essential  to  examine  the 

inguinal,  pelvic,  and  sublumbar  lymphatic  glands,  to  make  sure  that 

they  are  not  affected.  If  they  prove 
to  be  already  invaded,  an  operation 
should  be  avoided. 

Even  despite  such  precautions  and 
the  apparent  absence  of  any  glandular 
infection,  operation  may  be  followed 
by  generalisation  in  a  few  months, 
although  for  a  short  time  the  con- 
dition may  seem  to  have  greatly 
improved.  No  special  indications 
need  be  given  beyond  those  sug- 
gested as  necessary  in  dealing  wdth 
all  kinds  of  tumours,  whatever  their 
nature. 

The  skin  should  be  freely  divided, 
that  the  tumour  may  be  thoroughly 
dissected  out  and  no  fragments  be 
overlooked.  The  mass  of  the  tumour 
having  been  dissected  free,  the  ecra- 
seur  is  applied  to  the  pedicle  or  the 
cord.  Enucleation  of  the  tumour 
may  be  very  difficult  on  account  of 
the  presence  of  numerous  ramifica- 
tions or  attachments,  but  the  closest 
attention  must  be  given  to  removing 
every  fragment  if  a  fresh  local  growth 
is  to  be  avoided.  In  the  event  of 
fragments  being  left,  a  fresh  growth 
is  certain  to  occur. 

Generalisation,  which  may  extend 
to  all  the  viscera  (lymphatic  glands, 
liver,  spleen,  lungs,  pleura,  peri- 
toneum, heart,  etc.),  is  indicated  by 
rapid  wasting,  fever,  acceleration  of 
breathing,  digestive  disturbance,  and 
sometimes  coughing,  etc. 
Local   new  growths  assume  the  form  of  ulcerating  swellings.      In 

practice,  if  the  general  condition  can  be  improved  for  a  short  time,  it 
is  advisable  to  slaughter  the  animal. 


Fig.  240.  —  Eoof  of  the  neck  of 
the  bladder  and  first  part  of  the 
urethra  (mternal  surface).  1,  Ori- 
fice of  the  ureter  ;  2,  urethra  at  a 
pomt  bej'ond  the  urethral  valve ; 
3,  submucous  erectile  tissue  ;  4, 
urethral  sphincter ;  5,  vesiculse 
seminales  ;  6,  veru  montanum  ;  7, 
orifices  of  the  vesiculse  seminales  ; 
8,  orifice  of  the  vas  deferens ;  9, 
orifices  of  the  prostate  ;  10,  ureth- 
ral valve,  showing  on  its  free 
margin  the  point-like  openings  of 
the  ducts  of  Cowper's  gland.  (After 
Barrier.) 


ACCESSORY   GLANDS   OP   THE    GENITAL    APPARATUS. 


597 


ACCESSORY    GLANDS    OF    THE    GENITAL    APPARATUS. 

(prostate,  vesicul^  SEiriNALEs,  cowper's  glands.) 

inflammatory  or  other  diseases  of  the  above  glands  are  most  fre- 
quent in  entire  animals.  As  a  group  they  are  uncommon,  and  are 
still  ill-recognised  and  ill-described,  being  seldom  identified  excejDt  on 
post-mortem  examination. 

The  cause  of  inflammation  of  the  prostate,  of  the  vesicuhie  semi- 
nales,   and  of  Cowper's  glands  is  probably  an  ascending  infection  of 
the  urethra  and  neighbour- 
ing  channels,  a  fact  which  ^      " 
explains     the     comparative 
rarity  of  such  conditions  in 
castrated  animals. 

The  pathogenic  germs 
penetrate  from  the  urethra 
into  the  excretory  ducts  of 
the  glands,  obtain  a  lodg- 
ment in  the  culs-de-sac  of 
the  glands  themselves,  and 
thus  produce  simple  or  sup- 
purative inflammation. 

The  symptoms  may 
easily  be  mistaken,  to  some 
extent  at  least,  for  those  of 
acute  cystitis  or  cystitis  due 
to  the  presence  of  a  cal- 
culus, and  it  is  only  by 
rectal  examination  that  the 
diagnosis  can  be  made. 

The  first  symptom  is  defective  micturition,  which  occurs  in  jets, 
is  intermittent  and  painful,  and  sometimes  causes  slight  groaning. 
It  is  accompanied  by  vesical  colic,  spasmodic  lifting  of  the  hind  legs, 
and  more  or  less  unsuccessful  expulsive  efforts. 

These  symptoms  are  of  reflex  or  mechanical  origin,  and  are  due 
either  to  direct  compression  of  the  urethra  by  an  hypertroi^hied  and 
inflamed  gland,  or  to  spasm  of  the  vesical  sphincter.  The  urine 
passed,  unlike  that  in  cases  of  acute  cystitis  or  in  cystitis  due  to 
calculus,  is  of  a  normal  character.  Rectal  examination  usually  re- 
veals distention  of  the  bladder,  and  hypertrophy  and  exceptional  sen- 
sitiveness at  certain  points. 

If    the    painful    and    hypertrophied    area    is    over    the    neck    of   the 


Fig.  241. — View  of  Cowper's  gland  and  of  its  com- 
pressing muscles.  (After  Cocu.)  1,  Cowper's 
gland ;  2,  compressing  muscle  ;  3,  accelerator 
urinse  muscle  turned  back  to  expose  the  gland ; 
4,  sphincter  of  the  urethra. 


598  MALE  GENITAL  ORGANS. 

bladder,  this  indicates  that  the  lobes  of  the  prostate  are  affected. 
If,  however,  the  affected  parts  are  situated  on  the  sides  of  the  neck 
and  along  the  posterior  pointed  end  of  the  bladder  (Fig.  239),  the 
vesiculse  seminales  are  affected ;  finally,  if  the  painful  points  are 
directly  above  the  ischial  arch  and  below  the  sphincter  ani,  Cowper's 
glands  are  the  seat  of  disease  (Fig.  240). 

To  diagnose  these  conditions  requires  very  close  and  careful  exami- 
nation. They  may  easily  be  mistaken  for  acute  cystitis,  though  the 
character  of  the  urine  should  suggest  doubts  and  lead  to  rectal  exami- 
nation. 

Although  they  do  not  endanger  the  animal's  life,  these  condi- 
tions give  rise  to  such  serious  inconvenience  as  often  to  render  entire 
animals  useless  for  stud  purposes. 

Local  treatment  is  imj^ossible,  and  the  practitioner  is  restricted  to 
the  use  of  anodynes,  l)alsamic  preparations  and  diuretics.  The  treat- 
ment, in  fact,  differs  little  from  that  of  cystitis.  In  cases  of  suppu- 
ration of  Cowper's  glands,  the  abscess  usually  forms  just  below  the 
anus  and  close  to  the  median  line.  Thus  the  diagnosis  may  be  con- 
firmed by  capillary  puncture,  the  part  being  laid  open  if  necessary. 


SECTION   VIII. 

DISEASES  OF  THE    SKIN   AND    SUBCUTANEOUS 
CONNECTIVE    TISSUE. 

CHAPTER    I. 

ECZEMA. 

Under  the  name  of  eczema  may  be  grouped  a  series  of  cutaneous 
diseases  characterised  by  pruritus,  by  a  discharge  from  the  skin,  or 
simply  by  epidermic  prohferation,  without  any  apparent  parasitic  or 
accidental  cause. 

These  diseases  have  been  referred  to  a  special  constitutional  con- 
dition termed  a  diathesis,  although  during  the  last  few  years  we  have 
come  to  recognise  certain  microbic  and  toxic  influences  in  their  pro- 
duction. In  the  ox  eczema  assumes  different  appearances.  Accord- 
ingly, the  disease  has  been  divided  into  the  acute,  chronic,  sebaceous, 
and  toxic  forms. 

ACUTE    ECZEMA. 

Causation.  In  the  ox,  as  in  all  other  species,  the  determining 
cause  is  to  be  found  in  bad  hygienic  conditions,  improper  feeding, 
and  in  a  special  individual  condition  of  the  animal  affected,  that  is 
to  say,  a  diathesis. 

Symptoms.  During  a  preliminary  period,  which  might  be  termed 
a  prodromic  period,  only  general  symptoms  can  be  detected,  such  as 
fever,  loss  of  appetite,  digestive  disturbance,  constipation,  etc.  Local 
signs  are  still  absent,  or  at  least  are  not  noticeable,  and  are  only 
represented  by  congestion  of  the  skin. 

The  second  phase  is  characterised  by  a  papulous  eruption  which 
is  difficult  to  detect,  inasmuch  as  it  occurs  in  the  depths  of  the 
coat.  Nevertheless,  the  skin  is  distinctly  sensitive,  and  at  numerous 
small  points  the  hairs  appear  to  stand  upright. 

The  third  phase  consists  in  the  development  of  more  or  less  con- 
fluent vesicles,  with  exudation  and  discharge.  The  disease  is  not 
really  visible  externally  until  after  the  hair  has  become  agglutinated 


600  ECZEMA. 

by  the  discharge.  This  discharge  is  seldom  as  abundant  as  in  eczema 
in  the  dog  or  horse.     It  is  produced  slowly  and  dries  rapidly. 

As  the  crusts  fall,  carrying  with  them  a  portion  of  the  hair,  the 
general  symptoms  disappear,  but  the  sites  of  these  vesicular  patches 
now  show  cracks  extending  as  deep  as  the  dermis  and  often  compli- 
cated by  secondary  infection  involving  suppuration,  adenitis,  abscess 
formation,  or  diffuse  subcutaneous  suppuration. 

Acute  eczema  is  generally  confined  to  the  limbs.  It  may  develop 
fully  in  from  twenty-four  to  forty-eight  hours.  The  acute  stage  is 
attained  in  a  few  days,  and  the  condition  disappears  in  two  to  three 
weeks  provided  it  does  not  assume  the  chronic  form  as  the  result  of 
complications. 

Diagnosis.  The  absence  of  parasites  enables  the  condition  to  be 
distinguished  from  phthiriasis  and  acariasis,  whilst  the  history  pre- 
vents its  being  confounded  with  toxic  eczema. 

Prognosis.  The  condition  is  troublesome  rather  than  grave.  Sup- 
puration is  often  persistent,  and  despite  careful  attention  the  discharge 
may  only  diminish  slowly,  while  the  disease  is  always  liable  to  return. 

The  treatment  is  local  and  general.  Local  treatment  consists  in 
emollient  and  antiseptic  washes  and  the  application  of  drying  powders. 
The  former  comprise  glycerole  of  starch,  bran  water,  boric  ointments, 
camphorated  vaseline,  iodine  and  glycerine.  At  a  later  stage  the  skin 
can  be  washed  with  decoction  of  oak  bark  or  a  weak  iodine  solution, 
followed  by  the  application  of  talc  or  starch  powder.  As  far  as  pos- 
sible this  external  treatment  should  be  supplemented  by  the  frequent 
use  of  mild  purgatives  and  various  diuretics,  which  seem  to  have 
a  special  action  on  the  arthritic  diathesis. 

CHRONIC    ECZEMA. 

Comparatively  few  cases  of  chronic  eczema  have  hitherto  been  de- 
scribed in  oxen,  and  the  details  given  are  extremely  meagre.  Chronic 
eczema  may  assume  that  form  from  the  first  or  may  succeed  acute 
eczema.     The  causes  are  probably  the  same  in  both  conditions. 

The  symptoms  appear  to  be  those  of  the  acute  form,  but  are  much 
less  severe.  They  consist  in  papulation,  a  miliary  vesicular  eruption, 
pruritus,  and  the  formation  of  crusts  and  epidermic  scales. 

In  a  case  seen  by  Megnin  the  crusts  separated  and  fell  away, 
leaving  bare  spots.  The  disease  re-appeared  for  several  years  in  suc- 
cession. The  spots  finally  remained  bare,  but  showed  no  thicken- 
ing of  the  skin  and  no  microscopic  changes. 

Diagnosis.  Microscopical  examination  is  necessary  to  distinguish 
this  disease  from  scabies  or  ringworm. 


SEBACEOUS  OR  SEBORRHChUC  ECZEMA.  601 

The  prognosis  is  grave,  because  large  areas  of  the  skin  may  he 
invaded  in  succession. 

Treatment.  As  in  acute  eczema,  the  condition  is  improved  by 
the  prolonged  administration  of  small  doses  of  salines  and  diuretics. 
Arsenical  prej^arations  are  also  valual)le,  but  should  only  be  employed 
for  two  or  three  weeks  together,  with  intervals  of  equal  duration. 
The  dangerous  complications  which  sometimes  result  from  accumula- 
tions of  this  drug  in  the  system  are  thus   avoided. 

SEBACEOUS    OR    SEBORRHCEIC    ECZEMA. 

Whilst  the  two  preceding  forms  of  eczema  result  from  vascular 
disturbance  of  the  skin  or  dermis  that  now  under  consideration  seems 


gg 

^M 

ll^HL'^^ 

■NRI 

hR 

lUn^^K.-^ 

1    P^  iP^ifc 

.<t 

sp^ 

1   /T"""^*^ 

fc--^ 

""^Hw           "^W" 

■  i  ^r  • 

f/ 

1 

*^,s*  ^ii*. 

1^. 

Fig.  242. — Sebaceous  eczema,  first  stage.     Depilation  of  tlie  extremities. 

due  to  vascular  and  secretory  troubles  in  the  accessory  structures  of 
the  skin,   and  more  particularly  in  the  sebaceous  glands. 

Symptoms.  The  disease  develops  slowly.  At  first  circular  or 
elliptical  patches  of  skin,  distributed  regularly  over  the  body,  more 
especially  round  the  natural  orifices,  become  deprived  of  hair.  The 
surface  of  these  patches  is  covered  either  with  thick  crusts  of  a  pecu- 
liar greyish-brown  tint  which  display  numerous  superficial  cracks,  or 
parts  normally  free  from  hair  exhibit  shining  epidermic  crusts  ar- 
ranged in  layers,  which  are  shed  on  the  slightest  touch. 

This  depilation  has  a  strong  tendency  to  spread,  and  so  at  first 
it  often    resembles   ringworm.      It  results    from   changes   in  the   hair 


60^ 


jac2iEMA. 


follicles,    with    atrophy    of    the    papillae    and    complete    loss    of    haii*. 
The    changes    in    the   skin,  however,  are    little    marked.      The    skin 


Fig.  243. — Sebaceous  eczema,  second  stage.     Partial  alopecia. 

itself   is   hut    slightly    thickened    and    preserves   its    usual    suppleness, 
while  the  suhcutaneous  tissue  is  not  cedematous. 


""^^^fii^- 


^^d 


Fig.  244. — Sebaceous  eczema,  third  stage.     Total  alopecia. 


The  hairs,  however,  when  examined  microscopically  are  found  to 
he  thickened  at  their  roots,  though  otherwise  throughout  their  whole 


ECZEMA    DUE   TO    FEEDING    WITH    POTATO    PtfLP.  G03 

length  they  remam  normal.  The  condition  is  a  consequence  of  dis- 
turbance in  the  circulation  and  nutrition  of  the  papilla  and  the  root 
of  the  hair. 

Finally,  the  congestive  process  extends  to  the  sebaceous  glands, 
the  secretion  of  which  it  modifies,  and  sets  up  seborrhcea,  which  is 
responsible  for  the  formation  of  the  crusts  and  epidermic  scales 
above-mentioned. 

The  pathogeny  of  the  disease  is  difficult  to  explain,  but  the  stages 
in  the  clinical  development  are  as  follows :  the  skin  undergoes  re- 
peated attacks  of  congestion,  followed  by  seborrhoeic  folliculitis,  epider- 
mitis  and  loss  of  hair. 

The  diagnosis  is  easy,  the  absence  of  ringworm  being  proved  by 
the  absence  of  the  spores  of  trichophyton  and  by  the  non-contagious 
character  of  the  discharge. 

The  prognosis  is  not  grave  from  the  point  of  view  of  general 
health,  the  chief  functions  being  perfectly  regular,  but  it  is  otherwise 
as  regards  possible  terminations,  viz.,  partial  or  total  loss  of  the  coat, 
which  may  be  irremediable. 

Treatment.  It  is  difficult  to  lay  down  a  really  satisfactory  method 
of  treatment,  because  the  exact  cause  of  seborrhcea  is  still  unknown. 
As  it  is  probably  to  be  sought  in  some  individual  constitutional 
peculiarity,  the  feeding  and  method  of  life  should  be  changed  and 
the  skin  stimulated  by  washing  with  lukewarm  water  and  soap  and 
by  dry  friction.  Locally,  if  the  alopecia  threatens  to  be  permanent 
stimulating  applications  may  be  tried.  These  comprise  lotions  con- 
taining alcohol,  solutions  of  chloral,  salicylate  of  soda,  etc.,  and  they 
should  be  applied  with  smart  friction. 

The  sufferers  should  not  be  used  for  breeding  purposes. 

ECZEMA     DUE    TO    FEEDING     WITH     POTATO     PULP. 

Among  the  forms  of  eczema  due  to  toxins,  several  varieties  may 
be  recognised.  Some  result  from  the  administration  of  drugs  such 
as  iodine,  others  from  special  forms  of  food.  The  only  one  of  clinical 
importance  is  that  following  the  consumption  of  excessive  quantities 
of  potato  pulp. 

Causation.  The  disease  is  seen  in  all  districts  in  which  potatoes  are 
employed  for  the  manufacture  of  alcohol  and  starch,  more  especially 
in  Germany.  The  disease  seems  to  be  a  direct  consequence  of  feeding 
with  residual  products  of  distilleries  and  starch  manufactories. 

Spinola  states  that  160  lbs.  of  potato  refuse  per  day  to  1,000  lbs. 
of  body  weight  would  certainly  produce  eczema  :  60  to  80  lbs.  only 
produce  it  in  rare  cases  and  20  to  40  lbs.  are  harmless. 


604  ECZEMA. 

There  is  a  further  point  to  consider  as  regards  the  variation  of 
potato  pulp  in  toxicity.  Potatoes  yield  a  more  or  less  active  residue, 
according  to  the  year  in  which  they  are  grown,  their  state  of  germi- 
nation, and  the  variety  to  which  they  belong.  Raw  or  cooked  potatoes 
may  produce  eczema  if  given  in  large  quantities  or  for  long  periods. 
Numerous  theories  have  been  advanced  as  to  the  nature  of  the 
morbid  disturbance  producing  eczema.  Some  authorities  declare  the 
appearance  of  the  disease  to  be  due  to  the  presence  of  a  toxic  principle 
contained  in  potatoes,  viz.,  solanin.  It  might  be  objected  that  this 
chemical  principle  only  exists  during  germination  while  potatoes  that 
have  not  undergone  germination  produce  the  disease.  Further,  the 
symptoms  of  poisoning  by  solanin  differ  from  those  of  this  form  of 
eczema,  among  which  loss  of  appetite,  for  instance,  or  stuj^ef action,  or 
narcosis  is  never  observable. 

According  to  other  writers  eczema  is  due  to  the  action  of  the 
lower  alcohols  contained  in  the  refuse  pulp,  but  again  these  pro- 
perties exist  in  brewers'  and  distillers'  grains,  the  consumption  of 
which  produces  no  bad  results.  Similar  objections  might  be  made 
regarding  the  suggested  action  of  the  acids  of  fermentation  (lactic, 
butyric,  and  acetic  acids,  etc.). 

Johne  blames  the  salts  of  potassium,  which,  how^ever,  can  only  act 
as  digestive  irritants,  and  Ziirn  suggests  mycosic  inflammation. 

Whatever  the  toxic  principle,  its  effects  are  most  marked  in 
animals  undergoing  fattening,  and  are  rarely  found  in  working  oxen, 
still  more  rarely  in  milch  cows.  In  the  last  named  the  injurious 
principle  appears  to  be  eliminated  in  the  milk,  and  this  theory  is 
supported  by  the  fact  that  the  liquid  has  purgative  properties ;  the 
calves  which  consume  it  suffer  from  diarrhcea,  which  ceases  when  the 
feeding  is  altered. 

Finally,  it  has  been  proved  that  different  animals  show  different 
degrees  of  susceptibility  to  the  action  of  potato  pulp. 

The  symptoms  do  not  appear  until  after  tw^o  or  three  weeks'  feed- 
ing on  the  potato  pulp.  Then  the  animals  walk  stiffly,  rise  with 
difficulty,  and  display  redness,  swelling  and  sensitiveness  of  the  limbs. 
When  the  cedematous  infiltration  and  reddening  have  become  dis- 
tinctly marked  there  appear,  not  only  betw^een  the  claws,  as  in  foot- 
and-mouth  disease,  but  over  the  entire  limb  and  principally  near  the 
folds  of  skin  about  the  joints,  numerous  closely-packed  small  papules, 
which  in  one  or  two  days  become  transformed  into  vesicles  through 
exudation  below  the  epidermis. 

This  marks  the  eczematous  phase  properly  so  called.  The  vesicles 
then  become  ruptured,  the  exuded  matter  glues  the  hairs  together, 
dries,  and  forms  crusts,  which  have  a  peculiar  and  distinctive  odour. 


IMPETIGO    IN    THE    PIG.  605 

The  disease  may  extend  towards  the  hocks,  the  knees,  the  stifle, 
the  armpit,  etc.  In  the  folds  of  skin  surrounding  the  joints  deep 
cracks  form,  and  sometimes  become  secondarily  infected,  thus  leading 
to  the  development  of  lymphangitis. 

General  symptoms,  such  as  fever,  loss  of  appetite  and  constipa- 
tion, always  follow ;  they  are  afterwards  succeeded  by  diarrhoea  and 
progressive  weakness,  ending  in  death. 

The  disease  is  easily  curable  if  seen  in  its  earlier  stages,  but  after 
all  signs  of  the  first  attack  have  disappeared,  the  condition  may  return 
five  or  six  times  in  a  year  if  potato  pulp  is  again  given.  Recovery 
is  always  very  difficult  in  aged  or  enfeebled  patients. 

The  mortality  varies  greatly;  formerly  it  was  as  high  as  20  per 
cent.,  but  at  the  present  time  it  is  much  lower. 

Diagnosis.  Provided  the  history  of  the  case  is  borne  in  mind,  the 
diagnosis  is  always  easy. 

The  prognosis  is  not  grave  if  the  disease  is  treated  early. 

Treatment.  This  consists  first  of  all  in  altering  the  diet  and 
reducing  the  quantity  of  potato  pulp,  or,  better  still,  in  discontinuing 
it  entirely.  The  food  should  consist  of  good  hay,  bran,  oatmeal  gruel, 
pollard,  etc.  Internally,  diuretics  are  given  to  assist  in  the  elimination 
of  the  toxic  products. 

This  treatment  arrests  the  course  of  the  disease.  Suitable  local 
treatment  will  remove  the  existing  lesions.  It  is  precisely  similar  in 
character  to  that  of  acute  eczema,  but  it  must  be  borne  in  mind  that 
it  can  only  prove  effective  if  the  primary  cause  be  removed. 

IMPETIGO    IN    THE    PIG. 

The  term  impetigo  is  used  to  describe  a  disease  characterised  by 
an  eruption  of  papules,  the  discharge  from  which  forms  yellowish 
crusts,  which  when  dry  are  of  a  grey  or  brown  colour.  The  point  of 
origin  of  the  eruption  is  unknown,  but  the  crusts  rapidly  become 
infected  on  contact  with  the  air,  and  the  bodily  lesions  may  end  in 
suppuration.  The  disease  is  not  frequent  nowadays  except  in  sucking 
pigs  and  in  large  or  badly-kept  piggeries. 

Symptoms.  The  eruption  usually  appears  between  the  ages  of 
two  and  three  months,  and  is  accompanied  from  the  first  by  moderate 
pruritus.  The  papules  rupture  after  two  or  three  days  and  discharge 
a  lemon-coloured  liquid,  which  is  distributed  over  the  surface,  dries 
rapidly,  and  causes  the  bristles  to  stick  together  at  the  roots.  The 
crusts  formed  in  this  way  remain  adherent  to  the  skin,  though  their 
surface  becomes  cracked.  They  increase  in  thickness,  cover  the  head 
and  part  of  the  body,  particularly  the  belly  and  the  inner  surface  of 


606  ECZEMA. 

the  thighs,  and  if  removed,  an  operation  of  some  difficulty,  leave  ex- 
posed a  bleeding,  sanious,  or  purulent  wound.  The  animals  lose 
condition  and  appetite,  cease  to  grow,  seem  as  though  attacked  with 
rachitis,  and  may  die  if  the  general  conditions  of  their  maintenance 
are  not  improved. 

The  diagnosis  is  not  difficult,  but  the  prognosis  depends  on  how 
long  the  disease  has  existed  and  the  bodily  condition  of  the  patients. 

The  treatment  consists  entirely  in  improving  the  hygienic  condi- 
tions and  the  feeding.  The  patients  must  be  repeatedly  washed  or 
bathed  and  carefully  disinfected,  and  they  must  have  better  food. 

The  crusts  should  be  softened  before  the  animals  are  washed,  so 
that  bleeding  may  be  avoided  and  the  affected  areas  not  be  trans- 
formed into  suppurating  wounds.  By  applying  oil  or  some  fatty 
matter  to  the  crusts  it  is  possible  to  cleanse  the  parts  with  bran 
water.  If  considered  necessary,  this  cleansing  can  be  followed  by 
dressing  with  boric  or  weak  creolin  solution.  Open-air  life  and  good 
food  soon  relieve  the  principal  symptoms. 

ACNE    IN     SHEEP. 

Acne,  that  is  to  say,  localised  inflammation  of  the  sebaceous  glands 
and  hair  follicles,  sometimes  occurs  in  sheep  apart  from  any  parasitic 
invasion.  The  eruption  is  particularly  seen  after  shearing,  and  it  is 
probable  that,  as  in  the  horse,  irritation  produced  by  the  machine, 
and  possibly  by  accidental  infection,  constitute  the  principal  determining 
causes. 

Symptoms.  The  disease  is  indicated  by  the  appearance  of  cuta- 
neous pustules,  which  are  only  slightly  painful  on  pressure  and  which 
involve  the  entire  thickness  of  the  skin.  The  dermis  is  hardly 
congested,  and  no  constitutional  disturbance  occurs. 

Acne  lesions  may  be  more  or  less  confluent,  and  may  attain  the 
size  of  a  small  hazel-nut. 

The  diagnosis  presents  no  difficulty.  Puncture  or  incision  reveals 
the  fact  that  the  abscesses  are  filled  with  white  sebaceous  material  and 
are  quite  free  from  parasites. 

The  prognosis  is  not  grave.  Recovery  occurs  spontaneously  in  a 
few  weeks. 

Treatment.  Liquid  emollient  applications  and  the  opening  of  the 
small  follicular  abscesses  appear  to  represent  the  only  means  of 
hastening  recovery. 

FAGOPYRISM     (BUCKWHEAT    POISONING). 

Fagopyrism  is  a  disease  of  toxic  origin  in  sheep,  and  is  due  to 
eating  buckwheat  {Puli/(j<>nnin  f(i(j(>2)i/runi). 


FAGOPYRISM    (BUCKWHEAT    POISONING).  607 

The  disease  has  also  been  entitled  erysipelatous  or  gangrenous 
dermatitis,  according  to  its  form  and  gravity. 

Causation.  The  cause  is  extremely  simple,  viz.,  the  consumption 
of  buckwheat  and  other  food  pertaining  to  a  like  species,  such  as 
Polygomnn  j^ersicaria.  The  green  plant  and  the  straw  give  the  same 
results,  but  the  action  of  light  and  air  are  also  necessary  for  the 
production  of  the  disease,  a  fact  which  is  somewhat  difficult  to  explain. 

According  to  German  writers  the  disease  occurs  more  frequently  in 
white  sheep  and  lambs  than  in  those  in  which  the  skin  is  of  a  very 
dark  colour. 

Symptoms.  When  the  sheep  are  fed  in  folds,  with  the  green  plant  in 
summer  or  with  the  straw  in  winter,  nothing  unusual  is  seen,  the  herds 
being,  to  all  appearance,  in  perfect  health.  On  their  being  set  at  liberty, 
however,  the  first  symptoms  appear,  perhaps  in  less  than  an  hour. 
Some  animals  become  restless,  make  peculiar  movements  of  the  head, 
■  and  soon  display  intense  congestion  of  the  parts  free  of  wool,  together 
with  redness  and  swelling  of  the  ears,  eyelids,  face,  throat,  etc.  The 
condition  develops  with  extreme  rapidity,  the  animals  being  immediately 
afflicted  with  pruritus  over  the  affected  regions.  If  they  are  not  re- 
moved to  the  quiet  and  warmth  of  the  fold  the  symptoms  increase 
and  papules  appear,  which  may  be  transformed  into  vesicles  and  bullfe. 
In  the  fold,  on  the  other  hand,  all  the  symptoms  rapidly  disappear. 

The  disease  rarely  assumes  an  erysipelatous  form,  but  respiratory  and 
cerebral  symptoms,  together  with  fever  and  vertigo,  are  not  exceptional. 

Treatment.  The  feeding  on  buckwheat  should  at  once  be  discon- 
tinued, and  the  patients  should  be  kept  in  the  fold  until  the  toxic 
principles  have  been  eliminated,  that  is,  for  a  month  or  more. 

Bicarbonate  of  soda  may  be  added  to  the  drinking  water.  The 
local  lesions  about  the  head  must  be  kept  clean  and  dressed  with  anti- 
septic astringent  lotions. 


CHAPTER     II. 
PHTHIRIASIS. 

The  term  plithiriasis  is  applied  to  infestation  of  the  sldn  with  lice. 

Causation.  These  diseases  are  due  to  the  presence  of  various  para- 
sites which  live  by  destroying  the  epidermic  scales,  or  by  piercing  the 
superficial  layers  of  the  skin.  They  are  of  a  greyish-yellow  colour,  and 
belong  to  the  genera  Hcematopinus  and  Tricliodrctes. 

The  Hfematopinus  forms  have  pointed   heads,  and  are  equipped  for 


Fig.  245. — Hceniatoinnns  curysternus  of 
the  ox,  magnified  20  diameters.  (After 
Neumami.) 


Fig.  246. — Hcematojnnus  of  the  calf, 
magnified  20  diameters.  (After 
Neumann.) 


.penetrating  the  sldn  by  suction.  The  Trichodectcs  have  a  large  fiat 
head  constructed  for  masticating. 

The  ox  harbours  two  forms  of  ILematojnnus  and  one  of  Trkhodectes, 
the  Hfematopinus  envy stc runs  and  tenuirostnis,  and  the  Trkhodectes 
scalaris. 

The  sheep  suffers  from  Trkhodectes  spherocephalus  and  a  Melophagits, 


PHTHIRIASIS. 


609 


the  goat  from  the  Hccmatopinus  stenops  and  the  Trichodectes  climax,  and 
the  pig  from  the  Hfeniatojmius  lirius. 

The  symptoms  are,  with  trifling  variations,  the  same  in  all  domestic 
animals,  the  principal  being  rubbing  and  itching.  The  animals  scratch, 
bite  and  attempt  to  rub  against  hard  objects,  even  abrading  the  skin 
when  this  is  thin  and  the  irritation  is  severe. 

The  parasites  may,  however,  remain  localised,  and  it  rarely  happens 


vU- 


^I'ji^ 


:/^nf     ^ 


Fig.  247. — Sheep  louse  {Tricliocephalns  si^liwrocephaltis).  a.  Female  ;  6,  antenna 
c,  d,  dorsal  and  side  view  of  leg.  Enlarged.  (After  Osborn,  1896 ;  Bui.  No.  5. 
Div.  Entomology,  Dept.  Agr.) 


that  they  are  present  in  any  considerable  number  in  all  parts  of  the 
body . 

In  the  ox  they  are  principally  found  in  the  depression  at  the  back 
of  the  base  of  the  horns,  and  in  the  upper  margin  of  the  neck  and  the 
back.  In  the  absence  of  treatment  phthiriasis  may  become  generalised 
over  the  entire  surface  of  the  body. 

The  trichodectes  and  the  melophagus  of  the  sheep  choose  similar 
points,  but  when  the  wool  is  long  they  may  be  found  nearly  all  over 
the  body. 

In  the  pig  the  hfematopinus  is  found  on  the  neck,  in  the  region  of 
the  poll,  about  the  armpits,  and  round  the  eyes  and  easr. 

D.C.  K  R 


610 


PHTHIRIA8IS. 


These  parasites,  whose  powers  of  increase  are  astonishing,  keep  the 
patients  in  a  continual  state  of  irritation,  causing  them  to  lose  con- 
dition and,  in  the  absence  of  treatment,  to  die  of  exhaustion. 

The  diagnosis  is  very  easy,  the  parasites  being  visible  to  the  naked  eye. 

The  prognosis  is  not  grave  unless  the  condition  affects  a  large 
number  of  animals  in  herds.  In  young  animals  the  prognosis  is  much 
graver,  for  the  little  creatures  rapidly  become  anaemic  and  die  in  a 
state  of  exhaustion. 

Treatment.  When  the  byre,  fold,  or  piggery  is  infested  the  first  point 
is  to  remove  the  animals  and  thoroughly  disinfect  and  cleanse  all  parts. 


Fig.  248. — Sheep  foot  louse  {Hceviatopinus  pedalis). 
view  of  terminal  segment  of  same,  showing  brushes  ; 


a,  Adult  female  ;    b,  ventral 
c,  terminal  segments  of  male  ; 


d,  egg.     Enlarged.     (After  Osborn,  1896;  Bui.  No.  5,  Div.  Entomology,  Dept.  Agr.) 


After  the  manure  has  been  cleared  out,  the  walls,  mangers,  racks, 
etc.,  are  washed  with  boiling  water,  or,  better  still,  potash  solution,  and 
disinfected  first  with  vaporised  sulphurous  acid,  then,  if  necessary,  with 
a  washing  of  caustic  lime.  ' 

The  patients  are  afterwards  clipped,  washed  with  soft  soap  and 
dressed  with  anti-parasitic  solutions,  such  as  1  per  cent,  tobacco  juice, 
or  a  mixture  of  equal  parts  of  benzine  and  oil  or  benzine  and  petroleum, 
etc.,  which  give  excellent  results. 

A  3  per  cent,  creolin  solution  is  also  a  very  active  anti-parasitic  and 
very  easy  to  use. 


SCABIES    IN    SHEEP. 


611 


All  these  solutions,  however,  are  more  or  less  poisonous  and  need 
to  be  used  with  caution,  weak  solutions  only  being  used  at  first,  par- 


.>r^^=^ 


Fig.  249. — Adult  sheep  tick  {Melo2)liagus 
oviniis).  (a)  Tick  ;  (6)  puparium.  Magni- 
fied. (Salmon  and  Stiles,  Annual  Keport, 
U.S.A.  Dept.  of  Agi-iculture,  1897,  p.  103.) 


¥10.250.— Tricho- 
clectes  scalaris 
of  the  ox.  Mag- 
nified 20  dia- 
meters. (After 
Railhet.) 


ticularly  in  the  case  of  animals,  such  as  oxen,  which  are  given  to  licking 
themselves. 

SCABIES— SCAB— MANGE. 

The  term  scabies  is  given  to  a  group  of  diseases  affecting  man  and 
all  domestic  animals.  These  diseases  are  produced  by  two  classes  of 
parasites,  viz.,  sarcoptinse,  which  live  within  the  epidermis  or  on  the 
surface  of  the  skin,  and  demodectes  {sing,  demodex),  which  penetrate 
into  the  sebaceous  glands  and  hair  follicles. 

Scabies,  though  known  from  the  earliest  times,  has  long  been  con- 
founded with  constitutional  diseases  characterised  by  cutaneous  erup- 
tions. The  symptoms  shown  were  formerly  regarded  as  due  to  the 
elimination  of  "humours"  which  the  organism  was  casting  off,  for 
which  reason  scabies  was  even  treated  with  internal  medicines. 

At  the  present  time  the  cause  of  the  disease  is  perfectly  well  under- 
stood, as  well  as  the  mode  of  development  of  the  different  parasites. 
The  rate  at  which  these  parasites  develop  is  almost  incredible,  a  fact 
which  explains  the  highly  contagious  character  of  the  disease. 

Each  species  of  animal  may  present  several  varieties  of  scabies, 
caused  by  different  parasites,  such  as  sarcoptes,  psoroptes,  chorioptes, 
demodectes,  etc. 

SCABIES    IN    SHEEP. 

Scabies  in  sheep  usually  assumes  one  of  three  forms — sarcoptic, 
psoroptic,  or  chorioptic  scabies.     Follicular,  or  demodectic,  mange  affects 

R  K  2 


612 


SCABIES — SCAB — MANGE. 


the  eyelids,  and  is  very  rare.     It  is  produced  l)y  the  Dcniodci-  foU'u-u- 
lonim  var.  oris. 


SARCOPTIC     SCAUIES. 

This  scahies  has  long  heen  recognised  as  affecting  more  especially 
the  head,  muzzle,  etc.  It  was  mentioned  as  long  ago  as  the  fourteenth 
century  by  Jehan  de  Brie,  hut,  until  Delafond's  time,  no  one  recognised 
that  it  was  caused  by  an  acarus.  In  1858  Delafond  discovered  the 
parasite  in  Piedmont  sheep. 

Causation.  Formerly,  writers  on  the  subject  and  sheplierds  attri- 
buted this  disease  to  the  wounds  and  excoriations  which  sheep  receive 
in  passing  through  brambles,  holly,  etc.,  or  in  rubbing    against   their 

racks.  The  true  cause  of  the  disease 
is  the  presence  under  the  skin  of  the 
Sarcopics  scahei  var.  avis,  which  passes 
from  sheep  to  sheep  by  direct  con- 
tact. The  animals  attempt  to  rub 
against  everything  about  them,  even 
against  their  neighbours.  These  para- 
sites can  be  transferred  from  the  goat 
to  the  sheep,  and  vice  versa. 

Walraff,  Eoloff,  Delafond,  Gerlach 
and  Eailliet  have  described  cases  of  in- 
fection in  man,  but  the  disease  is  rarely 
more  than  of  a  temporar}^  character. 

Symptoms.  This  form  of  scabies 
affects  the  head  and  the  parts  free 
from  wool. 

At  first  the  parasites  invade  the 
upper  lip  and  the  tissues  about  the 
nostrils,  sometimes,  but  more  rarely, 
the  eyes  and  ears.  They  cause  the 
formation  of  vesicular  papules,  ac- 
companied by  violent  itching.  The 
animal,  in  rubbing  itself,  excoriates  these  papules,  which  discharge  a 
fluid  and  soon  become  covered  with  yellowish-brown  crusts. 

The  disease  afterwards  invades  the  face,  forehead,  jaws,  and  entire 
head.  The  skin  becomes  wrinkled  and  the  brownish  crusts  thicker 
and  more  abundant.  These  are  fissured  and  bleeding,  and  they  give 
the  face  the  appearance  of  one  vast  sore. 

The  parasite  rarely  attacks  the  region  of  the  elbow,  the  belly,  or 
the  inside  of  the  thigh.  The  disease  never  advances  in  parts  covered 
by  wool,  although  in  breeds  of  sheep  with  thick  wool,  such  as  are  found 


Fig.  251. — Sarcoptis,  magnified  100 
diameters.     (After  Eailliet.) 


SAHCOPTIC    SCABIES. 


613 


in  Algeria  and  Tunis,  the  sarcoptic  form  of  scabies  may  become 
generalised  and  attack  the  entire  bodj'.  The  extremities  of  the  limbs, 
however,  are  usually  attacked  after  all  the  head  has  become  involved. 

Throughout  the  course  of  the  disease  the  patients  scratch  and  rub 
themselves,  thus  tearing  off  the  crusts  and  causing  bleeding  and  the 
formation  of  new  crusts  of  a  blackish  hue.  This  form  of  scabies 
about  the  head  may  become  complicated  with  conjunctivitis,  the 
inflammation  extending  from  the  extremity  of  the  eyelids  to  the  con- 
junctiva. This  arises  from  the  fact  that  the  membrane  is  frequently 
injured  by  the  animal  rubbing  the  parts.  Conjunctivitis  may  be  so 
intense  as  to  lead  to  purulent  ophthalmia  and  the  loss  of  the  eye. 

Diagnosis.  Sar- 
coptic mange  in 
sheep  cannot  be 
mistaken  for  any 
other  disease  on 
account  of  its  lo- 
calisation. 

Prognosis.  The 
disease  is  not  very 
dangerous,  for  it 
is  easy  to  treat, 
though  if  left  to 
itself  it  might  in 
time  become  fatal. 

Treatment. 
Preventive  treat- 
ment consists  in 
isolating    diseased 

animals,  cleansing  and  disinfecting  the  folds,  and  preventing  the  in- 
troduction of  diseased  animals  into  healthy  flocks. 

Curative  treatment.  When  the  disease  is  detected  at  an  early 
stage  anti-psoroptic   remedies  may  be  directly  employed. 

If,  however,  it  is  of  old  standing,  the  crusts  must  first  be  softened 
and  removed  by  the  use  of  fatty  substances,  such  as  vaseline  or  oil, 
before  any  curative  treatment  can  be  undertaken. 

The  crusts  can  be  removed  in  from  twenty-four  to  forty-eight 
hours  by  vigorous  washing  with  soft  soap  and  the  application  of  anti- 
parasitic solutions.  The  omission  to  wash  the  parts  causes  drugs  to 
lose  much  of  their  efficacy. 

Helmerich's  ointment,  oil  of  cade,  mixtures  of  oil,  benzine  and 
petroleum,  and  3  per  cent,  to  4  per  cent,  of  tobacco  juice,  are  the 
commonest  and  most  efficacious  applications. 


Fio.  252. 


-Sarcoptic  mange  of  the  sheep,  showing  the 
appearance  of  the  head. 


614  SCABIES — SCAB— MANGE. 

A  non-i:)oisoiious  ointment  may  be  made  b}'  taking  4  ounces  of  oil  of 
turpentine,  6  ounces  of  flowers  of  sulphur,  and  1  lb.  of  lard.  Mix  the 
ingredients  at  a  gentle  heat,  and  rub  in  well  with  the  hands  or  with  a 
brush,  at  the  same  time  breaking  the  crusts.  The  simple  sulphur  oint- 
ment may  be  made  of  one  part  of  sulphur  and  four  parts  of  lard ;  one 
fourth  i)art  of  mercurial  ointment  may  be  added.  Few  remedies  are  so 
useful  as  sulphur  iodide,  and  it  may  well  be  given  a  trial  on  head  scab. 

In  most  countries  this  disease  has  been  made  the  subject  of  special 
legislation. 

PSOROPTIC    MANGE SHEEP    SCAB. 

This  is  probably  the  gravest  form  of  mange.  It  was  described  by 
Cato  the  Censor  in  160  B.C.,  by  Virgil,  Juvenal,  Celsius,  Columella, 
Pliny,  Yegetius,  etc.  In  1787  Abildgaard  first  showed  that  psoroptic 
mange  in  sheep  could  be  cured  by  simple  external  remedies,  without 
internal  medications.  In  1809  Walz  described  the  causes,  nature, 
seat,  and  treatment  of  the  disease. 

Since  then,  the  parasitic,  contagious  nature  of  mange  or  scabies 
has  been  more  and  more  clearly  recognised. 

Causation.  Experience  and  observation  have  long  shown  that  the 
only  cause  is  the  presence  of  the  PsoruiJtes  communis  (oris).  This 
disease  is  much  more  contagious  than  that  just  described.  Psoroptic 
mange  or  scabies  exclusively  affects  those  portions  of  the  body  covered 
l)y  the  wool,  and  may  for  a  long  time  remain  unrecognised. 

The  parasite  is  visible  to  the  naked  eye,  though  most  inspectors 
employ  the  microscope.  The  adult  female  is  about  4^0  of  an  inch  long 
and  g\5  of  an  inch  broad ;  the  male  is  J^  of  an  inch  long  and  ^q  of  an 
inch  broad.  The  mites  are  discovered  more  easily  on  a  dark  back- 
ground, and  if  a  portion  of  the  wool  and  crusts  is  placed  on  black 
paper  and  exposed  to  the  sun  for  a  few  minutes  the  parasites  will 
generally  be  seen  crawling  about  on  the  paper. 

The  disease  is  transmitted  directly  or  indirectly  by  contact  from 
diseased  to  healthy  animals  in  the  folds,  fields,  or  sheep  runs.  One  dis- 
eased sheep  may  contaminate  an  entire  flock.  The  disease  is  extremely 
contagious,  and  may  appear  even  within  a  week  after  exposure. 

The  parasites  have  exceptional  vitality.  It  is  generally  stated  that, 
kept  at  a  moderate  temperature  on  portions  of  scab,  the  adults  may 
live  from  four  to  twenty  days,  but  they  will  occasionally  live  much 
longer ;  cases  are  on  record  where  they  have  lived  three,  four,  or 
even  six  weeks  when  separated  from  sheep  ;  if  the  atmosphere  is  dry 
they  will  generally  die  in  about  fifteen  days  ;  but  death  is  often  only 
apparent,  for  the  mites  may  sometimes  be  revived  by  warmth  and 
moisture  even  after  six  or  eight  weeks ;  the  fecundated  females  are 
especially  tenacious  of  life. 


PSOROPTIC    MANGE  — SHEEP    SCAB. 


615 


Experience  has  shown  that  in  some  cases  apparently  healthy  sheep 
have  become  infected  in  places  where  no  sheep  have  been  kept  for  four, 
eif^ht,  twelve,  or  even  twenty-four  months.     The  conditions  underlying 


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this  infection  are  not  thoroughly  understood.  Possibly  some  of  the 
eggs  have  retained  their  vitality  a  long  time  and  then  hatched  out; 
possibly  the  vitality  of  the  fecundated  female  has  also  played  a  role; 


016  SCABIES — SCAB — MANGE. 

while  it  is  not  at  all  improbal)le  that  an  entirely  new  infection  has 
accidentally  been  introduced  by  birds  or  other  animals.  Certain 
authors  of  high  standing  scout  the  idea  that  birds  can  introduce  an 
infection  of  scab,  but  there  is  no  reason  why  birds  should  not  do  this, 
and  there  are  some  reasons  for  believing  that  they  do.  It  has  been 
noticed  on  the  Experiment  Station  of  the  United  States  Bureau  of  Agri- 
culture, for  instance,  that  crows  delight  in  perching  on  the  backs  of 
scabby  sheep  and  picking  at  the  scab ;  while  so  doing  it  is  only  natural 
that  small  tags  of  wool  would  adhere  to  their  feet,  and  thus  scatter  scab. 

Delafond's  experiments  show  that  psoroptic  mange  is  most  trouble- 
some amongst  thin,  ill-nourished,  weakly  animals,  whilst  robust  sheep 
in  good  condition  may  be  cured  simply  by  attention  to  cleanliness  and 
abundant  feeding. 

In  America  this  disease  causes  extremely  heavy  pecuniary  loss 
second  only  in  importance  to  that  produced  by  hog  cholera.  It  has 
also  interfered  very  seriously  with  the  export  of  American  sheep. 

The  course  of  the  disease  is  affected  by  the  time  of  year  and  sur- 
rounding conditions.  In  autumn  and  winter,  when  sheep  are  in  con- 
tinual contact  in  a  moist,  w^arm  atmosphere  within  the  folds,  the 
disease  makes  rapid  progress.  Young,  weak,  closely-inbred  animals, 
and  those  with  long,  coarse  wool,  most  quickly  succumb.  Unhealthy 
surroundings,  damp,  and  bad  ventilation  favour  the  disease.  Pure  or 
mixed  bred  merino  sheep  suffer  severely.  In  summer  the  animals  are 
generally  shorn  and  live  in  the  open,  and  the  disease  then  usually 
diminishes  or  may  even  be  arrested. 

A  study  of  the  life  history  of  the  scab  parasite  is  necessary  in 
order  to  determine  several  important  points  of  practical  value,  such 
as  the  proper  time  for  the  second  dipping,  etc. 

The  female  mite  lays  about  fifteen  to  twenty-four  eggs  on  the 
skin,  or  fastened  to  the  wool  near  the  skin ;  a  six-legged  larva  is 
hatched  ;  these  larvre  cast  their  skin  and  become  mature  ;  the  mites 
pair  and  the  females  lay  their  eggs,  after  which  they  die.  The  exact 
number  of  days  required  for  each  stage  varies  somewhat,  according  to 
the  writings  of  different  authors,  a  fact  which  is  probably  to  be  ex- 
plained by  individual  variation,  and  by  the  conditions  under  which 
the  observations  and  experiments  were  made.  Thus  Gerlach,  in  his 
well-known  work  (1857)  estimates  about  fourteen  to  fifteen  days  as 
the  period  required  for  a  generation  of  mites  from  the  time  of  pair- 
ing to  the  maturity  of  the  next  generation.  He  divides  this  time  as 
follows  :  Under  ordinary  conditions  the  eggs  hatch  in  three  to  four 
days,  although  two  authors  allow  ten  to  eleven  days  for  the  egg 
stage  ;  three  or  four  days  after  birth  the  six-legged  larvae  moult  and 
the  fourth    pair  of  legs  appears ;    this  fourth    pair  is  ahva_)  s   present 


PSOROPTIC    MANGE — SHEEP   SCAB. 


617 


when  the  mites  are  two-thirds  the  size  of  the  adults  ;   when  seven  to 
eight  days  old  the  mites  are  mature  and  ready  to  pair  ;    sevei'al  (three 


^   ^ 


or  four)  days  are  allowed  for  pairing ;  another  generation  of  eggs 
may  be  laid  fourteen  to  fifteen  days  after  the  laying  of  the  first  gene- 
ration of  eggs.     Without  going  into  all  of  the  other  observations  on 


(jl8  SCABIES — SCAB— MANGE, 

these  points,  it  may  be  remarked  that  the  eggs  may  not  hatch  for 
six  or  seven  days ;  the  six-legged  larvie  may  moult  when  three  to 
four  days  old,  and  become  mature  ;  after  pairing,  a  second  moult 
takes  place,  lasting  four  to  five  days  ;  a  third  moult  follows  imme- 
diately, then  eggs  are  laid  and  the  adults  die ;  in  some  cases  there 
is  a  fourth  moult,  but  apparently  without  any  further  production  of 
eggs.  Accepting  Gerlach's  estimate  of  fifteen  days  as  an  average  for 
each  generation  of  ten  females  and  five  males,  in  three  months'  time 
the  sixth  generation  would  appear  and  consist  of  about  1,000,000 
females  and  500,000  males. 

Several  practical  lessons  are  to  be  drawn  from  these  figures  :  Firstly, 
it  is  seen  that  the  parasites  increase  very  rapidly,  so  that  if  scab  is 
discovered  in  a  fiock,  the  diseased  sheep  should  immediately  be  iso- 
lated ;  secondly,  if  new  sheep  are  placed  in  a  flock,  they  should  either 
first  be  dipped,  as  a  precautionary  measure,  or  they  should  at  least 
be  kept  separate  for  several  weeks  to  see  whether  scab  develops ; 
thirdly,  since  the  chances  for  infection  are  very  great,  the  entire  flock 
should  be  treated,  even  in  case  scab  is  found  only  in  one  or  two 
animals  ;  fourthly,  as  dipping  is  not  certain  to  kill  the  eggs,  the  sheep 
should  be  dipped  a  second  time,  the  time  being  selected  between  the 
moment  of  the  hatching  of  eggs  and  the  moment  the  next  generation 
of  eggs  is  laid.  As  eggs  may  hatch  between  three  and  seven,  possibly 
ten  or  eleven  days,  and  as  fourteen  to  fifteen  days  are  required  for  the 
entire  cycle,  the  second  dipping  should  take  place  after  the  seventh 
day,  but  before  the  fourteenth  day;  allowing  for  individual  variation 
and  variation  of  conditions,  the  tenth,  eleventh,  or  twelfth  day  will  be 
the  best  time  to  repeat  the  dipping. 

Symptoms.  Psoroptic  mange  attacks  the  parts  covered  with  wool, 
so  that  attention  is  only  drawn  to  the  disease  by  some  slight  injury 
to  the  fleece,  which  becomes  rough,  matted,  brittle,  and  liable  to  fall. 

Scabies  commences  with  intense  pruritus.  The  animals  scratch  and 
bite  themselves,  and  tear  away  the  fleece.  These  symptoms  become 
aggravated  when  the  animals  are  hot,  as,  for  instance,  when  travelling. 
If  the  sheep  have  travelled  through  mud,  the  fleece  becomes  matted 
on  the  neck,  behind  the  shoulders,  and  at  all  points  where  they  are 
able  to  scratch  themselves  with  the  hind  limbs. 

When  a  scabby  sheep  is  touched  at  a  diseased  point,  the  animal 
shows  pleasure  by  nibbling  and  moving  the  head  up  and  down. 

At  an  early  stage,  if  the  fleece  is  divided  and  the  skin  examined, 
little  papules  may  be  discovered  somewhat  less  in  size  than  a  lentil. 
They  are  of  a  yellowish  colour,  and  are  distinctly  visible  against  the 
reddish  colour  of  the  skin.  These  papules  are  due  to  the  attacks  of 
the  psoroptes. 


psoroptk;  mange — sheep  scab. 


619 


Fig  255.— Left  top  figure,  egg  of  mite  which  causes  common  sheep  scab ;  middle  top 
figure,  six-legged  stage  of  sheep  scab  mite  ;  right  top  figure  young  female  before 
ufoulting  foi  the  last  time,  dorsal  view  ;  middle  figure,  adult  male  parasite  of 
sarcoptic  scabies  of  man  (the  corresponding  parasite  of  sheep  is  very  siimlar), 
ventral  view,  X  250  (after  Blanchard)  ;  left  bottom  figure,  adult  female  parasite 
of  sarcoptic  scabies,  dorsal  view,  X  250  (after  Blanchard)  ;  right  bottom  figure, 
same,  ventral  view  (after  Blanchard).     All  greatly  enlarged. 


620  SCABIES — SCAB — MANGE. 

They  soon  become  more  numerous  and  even  confluent,  break  and 
discharge,  become  converted  into  pustules,  and  cause  the  formation 
of  crusts.  In  a  few  daj^s  the  diseased  points  are  covered  with  a 
squamous,  yellowish,  sticky  covering,  under  which  the  psoroptes  lie 
hidden  and  which  affords  them  nourishment. 

The  crusts  steadily  grow  thicker  and  lift  the  individual  fibres  of 
wool,  tearing  them  from  their  follicles,  so  that  patches  of  skin  become 
bare.  The  patches  thus  formed  increase  in  diameter,  for  the  acari 
leave  the  centre,  where  crust-formation  is  replaced  by  abundant  de- 
squamation of  the  epidermis.  The  sldn  is  thickened,  assumes  the 
character  of  parchment,  and  in  old-standing  cases  becomes  wrinkled. 

The  disease  always  commences  along  the  back,  withers,  loins,  and 
the  upper  part  of  the  quarters.  Thence  it  spreads  to  the  flanks  and 
sides  of  the  chest.  The  psoroptes  are  almost  exclusively  confined  to 
recently  affected  points  on  the  edges  of  the  scabby  patches.  They 
are  visible  to  the  naked  eye,  and  appear  as  little  whitish-brown 
points. 

Scab  is  specially  liable  to  attack  a  flock  containing  lambs  and 
yearling  sheep,  whose  skin  is  thin,  fine  and  supple,  and  therefore 
more  susceptible  to  their  attacks.  If  a  portion  of  a  scabby  flock  be 
shorn,  the  shorn  animals  will  probably  recover  on  account  of  the 
psoroptes  transferring  themselves  to  the  animals  with  long  fleeces. 

The  diagnosis  is  easy.  Psoroptic  mange  cannot  be  mistaken  for 
sarcoptic  mange,  on  account  of  the  different  points  affected. 

Psoroptic  mange  only  attacks  regions  covered  by  wool,  and  sarcoptic 
mange  those  free  of  wool.  A  microscopical  examination  of  acari  re- 
moved from  the  diseased  animals  will,  however,  immediately  remove 
all  doubt. 

Nor  can  the  disease  be  confounded  with  phthiriasis,  the  tricho- 
dectes  being  immediately  distinguished  from  the  psoroptes  by  their 
greater  size  and  the  shape  of  their  head.  Moreover,  they  are  usually 
to  be  found  on  the  front  portions  of  the  shoulders. 

It  is  more  likely  to  be  mistaken  for  another  disease,  termed  by 
some  writers  seborrhoea  and  studied  and  described  by  Delafond  under 
the  name  of  sebaceous  folliculitis.  This  disease  appears  mostly  in 
autumn,  and  attacks  animals  much  exposed  to  the  weather  and  on 
moist,  cold  soils.  It  begins  with  very  violent  pruritus,  followed  by 
biting  and  loss  of  portions  of  the  fleece.  The  skin  is  red,  inflamed 
and  painful,  and  the  wounds  are  covered  with  large  quantities  of 
yellowish  acid  discharge  of  a  sticky  and  offensive  nature.  The  treat- 
ment of  this  disease  consists  in  placing  the  sheep  in  clean,  dry,  well- 
ventilated  sheds.  Eecovery  is  assisted  by  clipi)ing  and  the  application 
of  some  emollient  dressing  to  the  diseased  parts. 


PSOROPTIC    MANGE — 8HEEP    SCAB.  621 

The  ease  with  which  the  disease  can  be  cured  and  the  absence  of  para- 
sites enable  one  to  readily  distinguish  it  from  psoroptic  mange  (scab). 

Prognosis.  The  disease  is  not  specially  grave,  so  long  as  only  a  few 
animals  are  affected,  for  it  is  not  difficult  to  cure  by  isolation,  good 
feeding,  and  proper  external  treatment ;  but  if  scab  appears  in  a  flock, 
the  freedom  with  which  the  animals  intermingle  is  such  that  all  are 
rapidly  attacked,  and  the  irritation  produced  at  once  checks  their  growth 
and  causes  loss  in  condition.  Many  ewes  give  birth  to  small,  feeble 
lambs,  which  are  almost  certain  to  die,  and  in  any  case  the  wool  is 
considerably  diminished  in  value, 

Delafond  estimated  that  psoroptic  mange  formerly  attacked  one 
thirty-fifth  of  all  the  sheep  in  France  every  year,  causing  damage  to 
the  extent  of  five  francs  per  head.  At  the  present  time,  and  since 
proper  sanitary  laws  have  been  instituted,  it  has  become  much  less 
common. 

During  the  bad  season  of  the  year  the  mortality  is  greater,  and 
may  reach  as  much  as  from  40  to  50  per  cent.  In  cases  where 
scab  is  accompanied  by  some  other  disease,  such  as  distomatosis,  it 
may  even  rise  to  80  per  cent. 

The  treatment  is  preventive  and  curative.  Preventive  treatment 
consists  in  separating  the  healthy  from  the  diseased  animals  and  in 
disinfecting  the  folds,  sheds,  etc. 

Curative  treatment.  The  first  point  in  this  treatment  consists  in 
improving  the  diseased  animal's  food  both  as  to  quality  and  quantity. 

It  is  to  be  observed  that  the  parasite  has  more  difficulty  in  living 
on  robust  and  well-nouiished  animals.  Moreover,  observation  shows 
that  transference  from  poor  land  to  rich  pastures  is  sometimes  in 
itself  sufficient  to  bring  about  a  spontaneous  cure.  Such,  at  least, 
is  the  belief  of  the  Spanish  sheep  farmers  in  Estramadura  and  of  the 
French  shepherds. 

The  shepherd  can  do  a  great  deal  to  arrest  the  course  of  the  disease. 
If  he  is  careful,  zealous,  intelligent  and  observant  he  will  quickly  note 
the  first  indications  of  the  disease  and,  by  isolating  the  animals,  check 
its  spread. 

The  second  point  consists  in  shearing  the  diseased  animals,  and 
this  must  be  carried  out  at  any  season  of  the  year.  The  money  loss 
is  sometimes  important,  but  must  be  met,  for  otherwise  treatment  is 
impossible.  In  cases  of  .localised  scab,  empyreumatic  oil,  oil  of  cade, 
solutions  of  sulphuret  of  potassium,  decoctions  of  black  hellebore  (water 
1  quart,  fresh  rhizome  4  ounces  or  dry  rhizome  2  ounces),  de- 
coction of  tobacco  and  diluted  tobacco  juice  (6  ounces  in  1  quart 
of  water)  have  been  recommended.  Such  local  treatment,  however, 
is  often  useless,  because  incomplete. 


622  SCABIES — S(.'AB — MANGE. 

When  scab  is  p;eneralised  and  it  is  impossible  to  define  the  parts 
attacked,  general  treatment  is  indispensable  and  the  diseased  sheep 
should  be  dipped. 

As  a  preliminary,  however,  and  in  order  to  make  sure  that  the 
application  will  produce  its  effect,  the  animals  after  shearing  should 
be  passed,  twenty-four  hours  before  the  medicinal  bath,  through  a  warm 
bath  containing  soap  in  order  to  soften  and  remove  the  scabs.  Appli- 
cations of  oil  or  some  fatty  substance  will  also  soften  the  scabs,  which 
may  afterwards  be  removed  with  a  scraper  without  producing  bleeding. 
One  pound  of  soft  soap  may  be  dissolved  in  fifty  quarts  of  water  and 
each  sheep  plunged  into  this  and  scrubl)ed  with  a  brush  for  a  few 
minutes.     Washing  alone  removes  a  large  number  of  the  parasites. 

Whatever  bath  be  used  it  should  not  be  given  until  four  or  five 
hours  after  the  last  feeding.  The  dips  most  popular  in  France  are 
as  follows  : — 

Tessier's  BafJi  (1810). 

(  Arsenious  acid .  .  .  .  .  .  1^  parts  or  lbs. 

For  100  sheep   .  .  . .   \  Sulphate  of  iron  .  .  .  .       10  ,, 

i  Water 100 

The  above  materials  should  be  boiled  for  ten  minutes,  and,  as  a 
consequence  of  the  chemical  fusion  which  occurs  in  the  process,  the 
proportion  of  arsenious  acid  dissolved  amounts  to  about  2  drachms 
per  quart  instead  of  3f  drachms. 

In  this  bath  the  arsenious  acid  acts  as  a  parasiticide  and  the 
sulphate  of  iron  as  an  astringent,  the  latter  checking  the  absorption 
of  toxic  principles  by  the  skin  and  sores,  and  preventing  the  sheep 
from  licking  themselves. 

Absorption  by  the  skin  is  not  so  dangerous  as  has  been  believed. 
Eossignol  has  shown  that  poisoning  need  not  be  feared  in  chemical 
baths  unless  the  proportion  of  dissolved  arsenic  is  above  150  grains 
per  quart,  especially  if  the  period  of  immersion  does  not  exceed  five 
minutes.  Even  pure  solutions  of  arsenic,  free  from  any  astringent, 
may  be  used,  provided  the  quantity  in  the  bath  does  not  exceed 
120  grains  per  quart. 

The  bath  should,  if  possible,  be  kept  warm — 85°  to  95°  Fahr. 
(30°  to  35°  C). 

Four  men  are  generally  employed  for  the.  operation.  One  drives 
in  the  sheep,  two  others  hold  and  brush  them  in  the  bath,  and  the 
fourth  holds  the  head  of  the  animal  above  the  liquid.  Tessier  re- 
commended gloves  for  the  use  of  the  operators,  but  experience  has 
shown  that  such  a  precaution  is  unnecessary.  The  udder,  and  par- 
ticularly the  teats,  of  ewes  with  yoang  may,  if  necessary,  be  smeared 


PSOROPTIC    MANGE — SHEEP    SCAB.  623 

with  some  fatty  substance,  such  as  vaseline  or  oil,  in  order  to  guard 
against  the  astringent  action  of  the  liquid. 

Each  sheep  is  plunged  in  the  bath  for  one  or  two  minutes,  or  five 
minutes  at  the  most.  All  the  diseased  spots  must  be  brushed,  rubbed 
and  cleansed ;  but  care  must  be  taken  not  to  make  them  bleed. 

Tessier  suggested  leaving  the  animals  for  twenty-four  hours  in 
some  disinfected  place,  without  straw  or  food,  to  prevent  these 
materials  from  being  wetted  by  the  liquid  which  runs  from  the 
fleece,  and  which,  if  afterwards  eaten,  might  have  a  poisonous  effect. 
Here,  again,  the  danger  has  been  exaggerated.  Delafond  has  shown 
that  sheep  may  be  given  a  fluid  ounce  of  Tessier's  bath  for  eight  days 
running  without  producing  the  slightest  unfavourable  symptom. 

Tessier's  bath  is  excellent  from  the  therapeutic  standpoint,  but  it 
imparts  a  yellow  tint  to  the  fleece,  which  is  thus  rendered  less  valuable. 
The  mixture  has  therefore  been  modified  in  various  ways. 

Clement's  Bath  (1846). 

/  Arsenious  acid    .  .  .  .  .  .  1'5  parts  or  lbs. 

For  100  sheep   .  .  .  .   J   Sulphate  of  zinc.  .  .  .  .  .  5  ,, 

(  Water 100 

In  this  bath  every  quart  contains  about  2^  drachms  of  arsenious 
acid.  Its  toxic  power,  therefore,  is  considerably  greater  than  that  of 
Tessier's  bath. 

Clement's  formula  has  one  drawback.  The  sulphate  of  zinc  may 
be  mistaken  for  a  non- astringent  alkaline  sulphate  (sulphate  of  soda), 
and  as  a  consequence  poisoning  may  occur,  as  experience  has  shown. 

Mathieu  of  Sevres  replaced  the  sulphate  of  iron  by  an  equal 
quantity  of  alum.  In  this  case,  each  quart  of  the  bath  contains 
2^  drachms  of  arsenious  acid. 

Clement's  and  Mathieu's  formulfe  have  given  just  as  good  results 
as  Tessier's. 

A  last  formula  is  that  of  Professor  Trasbot.  The  aloes  is  of  very 
little  use,  however,  because  it  is  almost  insoluble. 


For  100  sheep 


Arsenious  acid    .  .  . .  .  .  .  .        2  lbs. 

Sulphate  of  zinc  .  .  .  .  .  .  10    ,, 

Aloes        .  .  . .  . .  .  .  .  •       1    ,, 

^  Water 25  gallons. 


Condition  of  the  animals  after  the  hath.— On  leaving  the  bath 
the  abraded  parts  are  slightly  cauterised.  During  the  five  or  six 
following  days  the  skin  is  stiff,  and  covered  with  adherent  crusts 
over  the  points  attacked  by  the  parasites.  The  animals  no  longer 
scratch  or  bite  theinselves. 


624  SCABIES — SCAB — MANGE. 

Towards  the  eij^lith  day  the  crusts  fall,  the  skin  appears  supple 
and  of  a  pmk  colour,  and  the  wounds  cicatrise.  In  animals  which 
have  suffered  for  a  long  time  recovery  is  much  slower,  and  may 
extend  over  from  thirty  to  fifty  days.  The  wool  again  grows  soft 
and  bright,  while  the  sheep  rapidly  regain  their  spirits  and  condi- 
tion. The  cicatrisation  of  the  wounds  is  often  accompanied  by  intense 
itching,  which  must  not  be  taken  as  a  sign  of  the  persistence  of 
the  disease.  It  is  well,  however,  to  keep  the  animals  under  observation 
at  this  period. 

Under  any  circumstances,  six  weeks  or  two  months  should  always 
be  allowed  to  elapse  before  giving  a  second  bath.  Should  a  few  spots 
appear  to  be  attacked  secondarily,  they  may  be  moistened  with  a  little 
of  one  of  the  bath  liquids. 

In  Germany  the  creolin  bath  is  generally  employed  : 

f   Water  .  .  .  .  .  .      250  gallons  oi-  parts. 

For  100  sheep..  ..    \  ^^,^^^.^^  g.,. 

Each  sheep  is  bathed  a  second  time  after  an  interval  of  one  week,  the 
animal  being  immersed  for  three  minutes  in  the  bath  and  thoroughly 
scrubbed  with  a  brush.  The  efficacy  of  this  method,  however,  is 
less  certain. 

In  America,  where  the  flocks  are  large  and  scabies  is  frequent, 
sulphur  baths  are  employed,  the  baths  themselves  being  of  great  size. 
The  animals  are  forced  to  pass  through  them  and  remain  there  for 
some  minutes. 

The  size  and  value  of  American,  Australian,  and  New  Zealand 
flocks  demand  that  the  modes  of  treatment  practised  and  the  experi- 
ence gained  in  these  countries  should  receive  something  more  than  pass- 
ing notice.  We  therefore  purpose  giving  a  short  resume  of  some  parts 
of  the  very  valuable  monograph  on  sheep  scab  issued  in  1897  by  Dr. 
Salmon  and  Mr.  Stiles,  for  the  American  Bureau  of  Animal  Industry. 

In  selecting  a  dip  the  question  of  expense  will  naturally  arise; 
next,  the  question  as  to  whether  or  not  scab  actually  exists  in  the 
flock  to  be  dipped.  The  facilities  at  hand,  the  set-back  to  the 
sheep,  and  the  length  of  the  wool  are  also  matters  for  considera- 
tion, as  well  as  the  pastures  into  which  the  dipped  sheep  are  to  be 
placed. 

Ex'pense. — In  estimating  the  expense  one  should  consider  not  only 
the  actual  outlay  for  the  ingredients  of  the  ooze,  but  the  cost  of 
fuel  and  labour,  the  injury,  if  any,  to  the  sheep,  and  the  liability 
of  not  curing  the  disease.  It  is  much  more  economical  to  use  an 
expensive  dip  and  cure  scab,  than  it  is  to  use  a  cheap  dip  and  fail 
to  cure  it. 


PSOROPTIC   MANGE SHEEP   SCAB. 


625 


Does  scab  exist  in  the  Jiock  / — If  scab  does  not  actually  exist  and 
the  wool  is  long,  the  dipping  in  this  case  simply  being  a  matter  of 
precaution,  it  is  best  not  to  select  a  dip  containing  lime. 

The  facilities  at  hand  for  preparing  dip. — If  fuel  is  very  scarce, 
so  that  it  is  impracticable  to  boil  the  mixture  for  at  least  two  hours, 
the  lime-and-sulphiir  dips  should  not  be  selected. 

The  pastures. — In  case  it  is  necessary  to  place  the  dipped  sheep 
on  the  same  pastures  they  occupied  before  being  dipped,  it  is  always 


Fig.  256. — A  comparatively  early  case  of  common  scab,  showing  a  bare  spot 
and  tagging  of  the  wool. 


best  to  use  a  dip  containing  sulphur.  If  a  proprietary  dip  is  selected 
under  those  circumstances,  it  is  suggested  that  sulphur  be  added, 
about  1  lb.  of  flowers  of  sulphur  to  every  6  gallons  of  dip.  The 
object  in  using  sulphur  is  to  place  in  the  wool  a  material  which 
will  not  evaporate  quickly,  but  will  remain  there  for  a  longer  period 
of  time  than  the  scab  parasites  ordinarily  remain  alive  away  from 
their  hosts.  By  doing  this  the  sheep  are  protected  against  reinfection. 
Sulphur  is  one  of  the  oldest  known  remedies  for  scab ;  its  use 
is  best  known  in  the  tobacco-and-sulphur  dip  and  in  the  lime-and- 
sulphur  dip.  These  home-made  mixtures  are  the  two  dips  which 
D.c.  s  s 


626 


SCABIES— SCAB — MANGE. 


have  played  the  most  important  rfdes  in  the  eradication  of   scab  from 
certain  EngHsh  colonies,  and  their  use  is  extensive  in  America. 

The  Tohacco-and-SuJphur  Dip. 

The   formula  as   given   here,   and  as   adopted   by  the   New    South 
Wales   sanitary   authorities,    appears   to   have   first    been   proposed   in 


Fiu.  257. — A  slightly  advanced  case  of  common  scab. 


1854  by  Mr.  John  Rutherford.  "On  the  Hopkins  Hill  Station  Mr. 
Rutherford,  with  two  dressings  of  these  ingredients,  then  cured  over 
52,000  sheep  which  had  been  infected  for  eighteen  months.  Since 
then  millions  of  scabby  sheep  have  been  permanently  cured  in  Victoria 
in  the  same  way,  and  in  South  Australia  and  New  South  AVales 
hundreds  of  thousands  of  scabby  sheep  have  also  been  cleansed  with 
tobacco  and  sulphur.  Judging,  therefore,  from  the  experience  of  the 
three  colonies,  there  is  no  medicament  or  specific  yet  known  that 
can  be  compared  with  tobacco  and  sulphur  as  a  thorough  and  lasting 


PSOROPTIC   MANGE — SHEEP   SCAB.  627 

cure  for    scab  in    sheep."     (Dr.  Bruce,   Chief  Inspector  of   Sheep  for 
New  South  Wales.) 

The  proportions  adopted  by  Eutherford,  and  afterwards  made 
official  by  the  scab  sanitary  authorities,  are — 

Tobacco  leaves  .  .  . .  . .     1  lb. 

Flowers  of  sulphur  .  .  .  .  .  .  .  .  .  .      1  ,, 

Water  .  .  .  .  .  .  .  .  .  .  .  .  .  .      5  gallons. 

The  advantage  of  this  dip  lies  in  the  fact  that  two  of  the  best  scab 
remedies,  namely,  tobacco  (nicotine)  and  sulphur,  are  used  together, 
each  of  which  kills  the  parasites,  while  the  sulphur  remains  in  the  wool 
and  protects  for  some  time  against  reinfection.  As  no  caustic  is  used 
to  soften  the  scab,  heat  must  be  relied  on  to  penetrate  the  crusts. 

Directions  for  pre  paring  the  dip. — Infusing  the  tobacco  : — Place 
1  lb.  of  gold-leaf  or  manufactured  tobacco  for  every  G  gallons  of 
dip  desired  in  a  covered  boiler  of  cold  or  lukewarm  water,  and  allow 
to  stand  for  about  twenty-four  hours ;  on  the  evening  before  dipping 
bring  the  water  to  near  the  boiling  point  (212'^  Fahr.)  for  an  instant, 
then  remove  the  fire  and  allow  the  infusion  to  stand  overnight. 

Thoroughly  mix  the  sulphur  (1  lb.  to  every  6  gallons  of  dip 
desired)  with  the  hand  in  a  bucket  of  water  to  the  consistency  of 
gruel. 

When  ready  to  dip,  thoroughly  strain  the  tobacco  infusion  from 
the  leaves  by  pressure,  mix  the  liquid  with  the  sulphur  gruel,  add 
enough  water  to  make  the  required  amount  of  dip,  and  thoroughly 
stir  the  entire  mixture. 

Lime- and-Sidph ur  Dips . 

Under  the  term  "  lime-and-sulphur  dips"  is  included  a  large 
number,  of  different  formulae  requiring  lime  and  sulphur  in  different 
proportions. 

To  give  an  idea  of  the  variety  of  the  lime-and-sulphur  dips,  the 
following  list  is  quoted,  the  ingredients  being  reduced  in  all  cases  to 
avoirdupois  pounds  and  United  States  gallons : 

(1.)  The  original  "Victorian  lime-and-sulphur  dip,"  proposed  by 
Dr.  Eowe,  adopted  as  official  in  Australia  : 

Flowers  of  sulphur         .  .  .  .  .  .  .  .  .  .       20^  lbs. 

Fresh  slaked  Ihue  .  .  .  .  .  .  .  .  .  .  .  .        10^    ,, 

Water 100    gallons. 

(2.)   South    African    (Cape     Town)    official     lime-and-sulphur    dip, 
February  4th,  1897: 

Flowers  of  sulphur         .  .  .  .  .  .  .  .  .  .  .  .        20|  lbs. 

Unslaked  Imie     .  .  .  .  .  .  .  .  .  ......        16§    ,, 

Water 100    gallons. 

S  S   2 


628  SCABIES — SCAB — MANOR. 

(3.)   Fort  Collins  lime-and-sulphur  dii)  : 

Flowers  of  sulphur         . ,  . .  . .  . .  . .  . .       33  lbs. 

Unslaked  lime     . .  . .  .  .  . .  . .  . .  .  .       11     ,, 

Water 100  gallons. 

(4.)  A  mixture  which,  used  to  some  extent  by  the  Bureau  of 
Animal  Industry,  contams  the  same  proportions  of  lime  and  sulphur 
(namely,  1  to  3)  as  the  Fort  Collins  dip,  but  the  quantities  are 
reduced  to — 

Flowers  of  sulpluir  .  .  .  .  .  .  .  .        24  lbs. 

Unslaked  lime     .  .  .  .  .  .  .  .  .  .  .  .  .  .  8    ,, 

Water  .  .  .  .  .  .  .  .      100  gallons. 

In  case  of  fresh  scab  Formula  No.  4  will  act  as  efficaciously  as 
the  dips  with  a  greater  amount  of  lime,  but  in  cases  of  very  hard 
scab  a  stronger  dip,  as  the  Fort  Collins  dip,  should  be  preferred ; 
or,  in  unusually  severe  cases,  an  ooze  with  more  lime  in  proportion 
to  the  amount  of  sulphur,  such  as  the  Victorian  (No,  1)  or  the 
South  African   (No.  2)   dip  might  be  used. 

Prejudice  against  Liinc-ancl-Sidpliur  Dips. 

There  is  at  present  great  prejudice  (a  certain  amount  of  it  justi- 
fied, no  doubt)  against  the  use  of  lime  and  sulphur,  emanating 
chiefly  from  the  agents  of  patent  or  proprietary  dips  and  from  the 
wool  manufacturers. 

In  the  first  place,  it  is  frequently  asserted  that  lime  and  sulphur 
does  not  cure  scab.  Experience  in  Australia  and  South  Africa,  as 
well  as  in  America,  has  shown  beyond  any  doubt  that  a  lime-and- 
sulphur  dip,  when  properly  proportioned,  properly  prepared,  and 
properly  used,  is  one  of  the  best  scab  eradicators  known. 

It  is  claimed  by  some  that  it  produces  "blood  poisoning."  But 
the  cases  of  death  following  the  use  of  lime-and-sulphur  dips  have 
been  infinitesimally  few  when  compared  with  the  number  of  sheep 
dipped  in  these  solutions,  and  when  compared  with  the  deaths  which 
have  l)een  known  to  follow  the  use  of  certain  proprietary  dips.  The 
details  of  such  accidents,  so  far  as  they  have  been  reported,  have 
not  shown  that  death  was  due  to  any  properly  prepared  and  pro- 
perly used  lime-and-sulphur  dip.  It  is  highly  probable  that  the  cases 
of  so-called  "blood  poisoning"  of  shear-cut  sheep  are  generally  due  to 
an  infection  with  bacteria  in  stale  dip  containing  putrefying  material. 

The  greatest  objection  raised  against  the  use  of  lime-and-sulphur 
dip  is  that  it  injures  the  wool.  This  objection  is  raised  by  many 
wool  manufacturers,,  and  echoed  with  ever-increasing  emphasis  by 
the  manufacturers  of  prepared  dips ;    while,   after  years  of   extensive 


PSOROPTIC  MANGE — SHEEP  SCAB.  629 

experience  with  properly  prepared  dip,  its  injury  to  the  wool  is 
strongly  and  steadfastly  denied  by  the  Agricultural  Department  of 
Cape  Colony. 

It  is  believed  that  a  certain  amount  of  justice  is  attached  to  this 
objection  to  lime  and  sulphur  as  generally  used  ;  unless,  therefoi-e, 
lime  and  sulphur  can  be  used  in  a  way  which  will  not  injure  the 
wool  to  an  appreciable  extent,  we  should  advise  against  its  use  in 
certain  cases ;  in  certain  other  cases  the  good  accomplished  far  out- 
weighs the  injury  it  does.  Let  ns,  therefore,  examine  into  this 
damage  and  its  causes. 

The  usual  time  for  dipping  sheep  is  shortly  after  shearing,  when  ihe 


Fig.  258. — A  more  advanfced  case  of  conniion  scab. 

wool  is  very  short ;  whatever  the  damage  at  this  time,  then,  it  can  be 
only  slight,  and  the  small  amount  of  lime  left  in  the  wool  will  surely  do 
but  little  harm. 

In  full  fleece  lime  and  sulphur  will  cause  more  injury.  In  Australia 
the  deterioration  was  computed  by  wool  buyers  at  17  per  cent.,  although 
in  Cape  Colony  the  Department  of  Agriculture  maintains  that  if  properly 
prepared,  and  if  only  the  clear  liquid  is  used,  the  sediment  being  thrown 
away,  the  official  lime-and-sulphur  formula  will  not  injure  the  long  wool. 
The  United  Slates  Bureau  of  Agriculture  have  found  some  samples  of 
wool  injured  by  dipping,  while  on  other  samples  no  appreciable  effect 
was  noticeable. 

If  a  lime-and-sulphur  dip  is  used,  care  must  be  taken  to  give  the 


630  SCABIES— SCAB— MANGE. 

solution  ample  time  to  settle ;  then  only  the  cle:ir  liquid  should  he  used, 
while  the  sediment  should  be  discarded.  In  some  of  the  above  tests  on 
samples  of  wool  it  was  found  that  the  dip  with  sediment  had  produced 
very  serious  effects,  even  when  no  appreciable  effects  were  noticed  on 
samples  dipped  in  the  corresponding  clear  liquid. 

Experience  has  amply  demonstrated  that  a  properly  made  and 
properly  used  lime-and-sulphur  dip  is  one  of  the  cheapest  and  most 
efficient  scab  eradicators  known,  but  its  use  should  be  confined  to  flocks 
in  which  scab  is  known  to  exist,  and  to  shorn  sheep,  with  the  exception 
of  very  severe  cases  of  scab  in  unshorn  sheep.  It  should  only  be  used 
when  it  can  be  properly  boiled  and  settled.  The  use  of  lime-and-sulphur 
dips  in  flocks  not  known  to  have  scab,  especially  if  the  sheep  are  full 
fleeced,  cannot  be  recommended ;  in  such  cases  tobacco,  or  sulphur  and 
tobacco,  is  safer  and  equally  good. 

All  things  considered,  where  it  is  a  choice  between  sacriflcing  the 
weight  of  sheep  and  to  some  extent  the  colour  of  the  wool  by  using 
tobacco  and  sulphur,  and  sacrificing  the  staple  of  the  wool  by  using  lime 
and  sulphur,  the  owner  should  not  hesitate  an  instant  in  selecting 
tobacco  in  preference  to  lime.  The  loss  in  weight  by  using  tobacco  and 
sulphur  is  not  much  greater  than  the  loss  in  using  lime  and  sulphur, 
while  the  loss  in  staple  is  of  more  importance  than  a  slight  discoloration. 

Preparation  of  the  )ni,rt lire. —Take  8  to  11  lbs.  of  unslaked  lime, 
place  it  in  a  mortar-box  or  a  kettle  or  pail  of  some  kind,  and  add 
enough  water  to  slake  the  lime  and  form  a  "  lime  paste "  or  "  lime 
putty."  * 

Sift  into  this  lime  paste  three  times  as  many  pounds  of  flowers  of 
sulphur  as  of  lime,  and  stir  the  mixture  well. 

Be  sure  to  weigh  both  the  lime  and  the  sulphur.  Do  not  trust  to 
measuring  them  in  a  bucket  or  to  guessing  at  the  weight. 

Place  the  sulphur-lime  paste  in  a  kettle  or  boiler  with  about  twent}^- 
five  to  thirty  gallons  of  boiling  water,  and  boil  the  mixture  for  two  hours 
at  least,  stirring  the  liquid  and  sediment.  The  boiling  should  be  con- 
tinued until  the  sulphur  disappears,  or  almost  disappears,  from  the  sur- 
face; the  solution  is  then  of  a  chocolate  or  liver  colour.  Tlie  longer  the 
solution  boils  the  more  the  sulphur  is  dissolved  and  the  less  caustic  the 
ooze  becomes. 

Pour  the  mixture  and  sediment  into  a  tub  or  barrel  placed  near  the 

*  ]\Iany  persons  prefer  to  slake  tlie  lime  to  a  powder,  which  is  to  be  sifted  and 
mixed  with  sifted  sulphur.  One  pint  of  water  will  slake  3  lbs.  of  lime  if  the 
slaking  is  performed  slowly  and  carefully.  As  a  rule,  however,  it  is  Jiecessary  to  use 
more  water.  This  method  takes  more  time  and  requires  more  work  than  the  one 
given  above,  and  does  not  give  any  better  results.  If  the  boiled  solution  is  allowed 
to  settle  the  ooze  will  be  equally  safe 


PSOIlOPTrC   MANGE — SHKEP   SCAB. 


631 


dipping  vat  and  provided  with  a  bung-hole  about  4  inches  from  the 
bottom,  and  allow  ample  time  (two  to  three  hours,  or  more  if  neces- 
sary) to  settle. 

When  fully  settled  draw  off  the  clear  liquid  into  the  dipping  vat,  and 
add  enough  water  to  make  a  hundred  gallons.  Under  no  circumstances 
sJiould  the  sediment  he  used  for  dipping  purposes. 

To  summarise  the  position  of  the  United  States  Department  of 
Agriculture  on  the  lime-and-sulphur  dips: — When  properly  made  and 


Fig.  259. — A  shorn  sheep  with  large  bare  area  due  to  scab. 


properly  used  these  dips  are  second  to  none  and  equalled  by  few  as  scab 
eradicators.  There  is  always  some  injury  to  the  wool  resulting  from  the 
use  of  tliese  dips,  but  when  properly  made  and  properly  used  upon  shorn 
sheep,  it  is  believed  that  this  injury  is  so  slight  that  it  need  not  be  con- 
sidered ;  on  long  wool  the  injury  is  greater  and  seems  to  vary  with 
different  wools,  being  greater  on  a  fine  than  on  a  coarse  wool.  This 
injury  consists  chiefly  in  a  change  in  the  microscopic  structure  of  the 
fibre,  caused  by  the  caustic  action  of  the  ooze.  When  improperly  made 
and  improperly  used  the  lime  and  sulphur  dips  are  both  injurious  and 
dangerous,  and  in  these  cases  the  cheapness  of  the  ingredients  does  not 


032  SCABIES — SCAB — MANGE. 

justify  their  use.  In  case  scab  exists  in  a  flock  and  the  farmer  wishes  to 
eradicate .  it,  he  cannot  choose  a  dip  which  will  bring  about  a  more 
thorough  cure  than  will  lime  and  sulphur  (properly  made  and  properly 
used),  although  it  will  be  perfectly  possible  for  the  farmer  to  find  several 
other  dips  which  will,  when  properly  used,  be  nearly  or  equally  as  effectual 
as  any  lime-and-sulphnr  dip.  There  is  no  dip  to  which  objections  cannot 
be  raised. 

Arsenical  Dips. 

There  are  both  home-made  arsenical  dips  and  secret  proprietary 
arsenical  dips.  It  is  well  to  use  special  precautions  with  both,  because 
of  the  danger  connected  with  them.  One  of  the  prominent  manufac- 
turers of  dips,  a  firm  which  places  on  the  market  both  a  powder  arseni- 
cal dip  and  a  liquid  non-poisonous  dip,  recently  summarised  the  evils  of 
arsenical  dips  in  the  following  remarkable  manner  : 

"  The  drawbacks  to  the  use  of  arsenic  may  be  summed  up  somewhat 
as  follows :  (a)  Its  danger  as  a  deadly  poison.  (/>)  Its  drying  effect  on 
the  wool.  {(■)  Its  weakening  of  the  fibre  of  the  wool  in  one  particular 
part  near  the  skin,  where  it  comes  in  contact  with  the  tender  wool  roots 
at  the  time  of  dipping,  {d)  Its  not  feeding  the  wool  or  stimulating  the 
growth,  or  increasing  the  weight  of  the  fleece,  as  good  oleaginous  dips  do. 
(e)  The  danger  arising  from  the  sheep  pasturing,  after  coming  out  of  the 
bath,  where  the  wash  may  possibly  have  dripped  from  the  fleece,  or 
where  showers  of  rain,  after  the  dipping,  have  washed  the  dip  out  of  the 
fleece  upon  the  pasture.  (/)  Its  occasionally  throwing  sheep  off  their 
feed  for  a  few  days  after  dipping,  and  so  prejudicing  the  condition  of  the 
sheep.  ((/)  Its  frequent  effect  upon  the  skin  of  the  sheep,  causing  exco- 
riation, blistering,  and  hardness,  wliicli  stiffen  and  injure  the  animal, 
sometimes  resulting  in  death." 

Although  this  manufacturer  has  gone  further  in  his  attack  upon  arsenic 
than  the  United  States  Bureau  of  Agriculture  would  have  been  inclined 
to  do,  it  must  be  remarked  that  when  a  manufacturer  of  such  a  dip 
cannot  speak  more  highly  of  the  chief  ingredient  of  his  compound  than 
this  one  has  done  in  the  above  quotations,  his  remarks  tend  to  discredit 
dips  based  upon  that  ingredient.  Bruce,  the  Cliief  Inspector  of  Live  Stock 
for  New  South  Wales,  speaking  of  arsenical  dips,  says:  "Arsenic  and 
arsenic  and  tobacco  (with  fresh  runs)  cured  9,284  and  failed  with  9,271." 

It  may  be  said,  on  the  other  hand,  that  arsenic  really  has  excellent 
scab-curing  qualities ;  it  enters  into  the  composition  of  a  number  of  the 
secret  dipping  powders,  and  forms  the  chief  ingredient  in  one  of  the 
oldest  secret  dips  used.  This  particular  dip  lias  been  given  second  place 
(with  some  qualifications)  among  the  officially  recognised  dips  in  South 
Africa. 


PSOROPTIC    MANGE — SHEEP    SCAB.  638 

Formvhe  for  arsenical  dij^s. — Finlay  Dun  recommends  the  follow- 
ing : — Take  3  lbs.  each  of  arsenic,  soda  ash  (impure  sodium  carbonate) 
or  pearl  ash  (impure  potassium  carbonate),  soft  soap,  and  sulphur.  A 
pint  or  two  of  naphtha  may  be  added  if  desired.  The  ingredients  are 
best  dissolved  in  10  to  20  gallons  of  boihng  water,  and  cold  water  is 
added  to  make  up  100  gallons.  The  head  of  the  sheep  must,  of  course, 
be  kept  out  of  the  bath. 

A  mixture  highly  endorsed  by  certain  parties  consists  of  the  following 
ingredients  : 

Commercially  pure  arsenite  of  soda    .  .  .  .  .  .      14    lbs. 

Ground  roll  sulphur        .  .  .  .  .  .  .  .  ..34^,, 

Water •.  .  .  .      432  gallons  (U.S.) 

The  arsenite  of  soda  is  thoroughly  mixed  with  the  sulphur  before 
being  added  to  the  water. 

Precautions  in  use  of  arsenical  mixtures. — Any  person  using  an 
arsenical  dip  should  bear  in  mind  that  he  is  dealing  with  a  deadly 
poison.     The  following  precautions  should  be  observed : 

(1)  Yards  into  which  newly-dipped  sheep  are  to  be  turned  should 
first  be  cleared  of  all  green  food,  hay,  and  even  fresh  litter  ;  if  perfectly 
empty  they  are  still  safer.  (2)  When  the  dipping  is  finished,  the  yard 
should  be  cleaned,  washed,  and  swept,  and  any  unused  ooze  should  at 
once  be  poured  down  a  drain  which  will  not  contaminate  food  or  premises 
used  by  any  animals.  (3)  Dipped  sheep  should  remain  in  an  open, 
exposed  place,  as  on  dry  ground.  (4)  Overcrowding  should  be  avoided, 
and  every  facility  given  for  rapid  drying,  which  is  greatly  facilitated  by 
selecting  fine,  clear,  dry  weather  for  dipping.  (5)  On  no  account  should 
sheep  be  returned  to  their  grazings  until  they  are  dry  and  all  risk  of 
dripping  is  passed. 

The  feeling  of  the  United  States  Bureau  of  Agriculture  towards  ar- 
senical dips  is  shown  by  the  following  : 

Suggestion  as  to  danger. — The  formulae  given  above  are  copied  from 
the  writings  of  men  who  have  had  wide  experience  in  dipping,  but  this 
Bureau  assumes  no  responsibility  for  the  efficacy  of  the  dips  given,  or 
for  their  correct  proportions.  Furthermore,  as  long  as  efficacious  non- 
poisonous  dips  are  to  be  had,  we  see  no  necessity  for  running  the  risks 
attendant  upon  the  use  of  poisonous  dips. 

Carbolic  Dips. 

This  class  of  dips  Idlls  the  scab  mites  very  quickly,  but  unfortunately 
the  wash  soon  leaves  the  sheep,  which  is  consequently  not  protected  from 
reinfection  in  the  pastures.     If,  therefore,  a  carbolic  dip  is  selected,  it  is 


634 


SCABIES — SCAB — MANGE. 


well  to  add  flowers  of  sulphur  (1  lb.  to  every  6  gallons)  as  a  protection 
against  reinfection. 

The  advantages  of  carbolic  dips  are  that  they  act  more  rapidly  than 
the  tobacco  or  sulphur  dips,  and  that  the  prepared  carbolic  dips  are  very 
easil}^  mixed  in  the  bath.  They  also  seem,  according  to  Gillette,  to  have 
a  greater  effect  on  the  eggs  of  the  parasites  than  either  the  sulphur  or 
the  tobacco  dips.  The  great  disadvantages  of  this  class  of  dips  are — first, 
in  some  of  the  proprietary  dips,  that  the  farmer  is  uncertain  regarding 
the  strength  of  material  he  is  using ;  second,  the  sheep  receive  a  greater 
set-back  than  they  do  with  either  lime  and  sulphur  or  tobacco. 


Fici.  260. — An  advanced  case  of  connnon  scab. 


The  United  States  Bureau  of  Agriculture  is  inclined  to  be  extremely 
conservative  in  regard  to  them,  and  to  advise  their  manufacturers  to 
prepare  them  in  a  guaranteed  strength  with  more  explicit  directions  for 
use  than  are  to  be  found  in  the  present  circulars. 

One  of  the  prominent  proprietary  carbolic  dips  was  formerly  recog- 
nised as  one  of  the  three  official  dips  in  New  South  Wales,  but  it  has 
now  been  erased  from  the  list.  In  Cape  Town  carbolic  dips  are  not 
much  used,  and  in  the  official  reports  little  is  said  concerning  them. 

The  United  States  Bureau  of  Animal  Industry  gives  the  following 
advice  as  regards  dipping : 

(1.)  Select  a  dip  containing  sulphur.  If  a  prepared  "dip"  is  used 
which    does   not    contain    sulphur,    it   is   always    safer  ■  to    add    about 


PSOROPTIC    MANGE — SHEEP   SCAB.  635 

16^  lbs.  of  sifted  flowers  of   sulphur    to   every    100   gallons    of  water, 


especially   if,    after   dipping,    the    sheep    have    to   be    returned    to   the 
old  pastures. 


636  SCABIES — SCAB — MANGE. 

(2.)  Shear  all  the  sheep  at  one  time,  and  immediately  after  shearing 
confine  them  to  one  half  the  farm  for  two  to  four  weeks.  Many 
persons  prefer  to  dip  immediately  after  shearing. 

(3.)  At  the  end  of  this  time  dip  every  sheep  (and  every  goat  also, 
if  there  are  any  on  the  farm). 

(4.)  Ten  days  later  dip  the  entire  flock  a  second  time. 

(5.)  After  the  second  dipping,  place  the  flock  on  the  portion  of 
the  farm  from  which  they  have  heen  excluded  during  the  previous 
four  or  five  weeks. 

(6.)  Use  the  dip  at  a  temperature  of  100°  to  110°  Fahr. 

(7.)  Keep  each  sheep  in  the  dip  for  two  minutes  by  the  watch — 
do  not  guess  at  the  time — and  duck  its  head  at  least  once. 

(8.)  Be  careful  in  dipping  rams,  as  they  are  more  likely  to  be 
overcome  in  the  dip  than  are  the  ewes. 

(9.)  Injury  may,  however,  result  to  pregnant  ewes,  which  must 
on  this  account  be  carefully  handled.  Some  farmers  arrange  a  stage, 
with  sides,  to  hold  the  pregnant  ewes,  which  is  lowered  carefully  into 
the  vat,  and  raised  after  the  proper  time. 

(10.)  In  case  a  patent  or  proprietary  dip,  especially  an  arsenical 
dip,  is  used,  the  directions  given  on  the  package  should  be  carried  out 
to  the  letter. 


CHORIOPTIC    MANGE,    SYMBIOTIC    MANGE,    FOOT    SCAB. 

This  disease  was  studied  in  Germany  by  Ziirn  in  1874,  and  by 
Schleg  in  1877.     It  has  not  yet  been  seen  in  France. 

Causation.  The  sole  cause  is  the  presence  of  Choriopics  acahici 
{v.  oris).  Contagion  is  favoured  by  the  animals  being  in  poor  con- 
dition. The  disease  extends  very  slowly.  Only  2  to  3  per  cent,  of  tbe 
animals  are  affected,  and  the  sufferers  are  usually  those  with  fine 
skins. 

German  shepherds  consider  this  disease  to  l)e  due  to  an  excessive 
allowance  of  salt,  because  it  is  most  common  during  the  winter,  when 
the  sheep  are  housed.     Needless  to  say,  this  theory  is  incorrect. 

Symptoms.  Sometimes  this  form  of  mange  attacks  the  limbs  and 
develops  very  slowly.  It  commences  about  the  pasterns,  and  gradu- 
ally extends  upwards  towards  the  knee  or  hock.  It  really  advances 
beyond  these  points.  The  parasites  are  much  smaller  than  those  of 
common  scab,  and  are  often  overlooked.  The  sheep  stamp  their  feet 
and  scratch  and  bite  the  infected  parts,  sometimes  transferring  the 
disease  to  the  lips  and  face,  where  it  may  jiersist  for  a  time. 

In  very  old  standing  cases  which  have  been  entirely  neglected, 
it    may   be    met    with   in    the    region    of    the    armpit   and    thigh,    the 


CHORIOPTIC   MANGE,   SYMBIOTIC   MANGE,    FOOT   SCAB. 


637 


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G38  SCABIES — SCAB — MANGE. 

limbs  becoming  swollen  so  as  to  suggest  lymphangitis.  In  the  folds 
of  the  hock  and  pastern  the  thickening  of  the  skin  may  lead  to  the 
formation  of  yellowish  or  brownish  crusts,  according  to  whether 
the  exudation  is  merely  of  a  serous  character  or  accompanied  by 
bleeding. 

The  diagnosis  is  easy.  The  parasites  are  found  in  the  thickness 
of  the  crusts,  and  are  readily  recognised  under  the  microscope. 

The  prognosis  is  not  grave,  because  of  the  comparative  rarity  of 
the  disease  and  its  mildly  contagious  character.  This  disease,  more- 
over, never  attacks  the  head  or  body,  but  remains  localised  in  the 
lower  portions  of  the  limbs. 

Treatment.  The  crusts  should  be  removed  by  washing  or  l)y  stand- 
ing the  animals  for  a  time  in  warm  water.  Simple  cleanliness  often 
suffices,  but,  to  save  time,  some  anti-i)arasitic  may  be  used.  The  con- 
dition is  easily  cured  even  without  disinfecting  tlie  folds. 

MANGE  IN  THE  OX. 
Bovine  animals  may  be  attacked  by  three  varieties  of  mange,   all 
of  which  have  long  been  known. 

SARCOPTIC    MANGE. 

This  is  not  of  any  great  clinical  importance,  as  it  is  purely 
accidental,  and  only  results  from  the  conveyance  of  sarcoptes  from 
other  animals,  such  as  the  horse,  sheep,  dog,  goat  or  cat,  to  an  animal 
of  the  bovine  species.  That  the  disease  does  occur,  however,  is  shown 
by  the  following  excerpt  from  a  report  by  Professor  McFadyean  : 
The  animal  showed  no  symptom  of  skin  disease  at  the  time  of  pur- 
chase, but  soon  after  it  was  brought  home  it  was  noticed  to  be  rub- 
bing, and  the  skin  began  to  assume  an  unhealthy  appearance.  When 
seen  in  January  (four  months  after  purchase)  it  was  rather  poor, 
although  it  had  been  in  very  good  condition  when  sold.  Almost  the 
entire  skin  had  become  affected,  including  that  of  the  legs  dowai  to 
the  top  of  the  hoofs.  There  had  been  extensive  loss  of  hair,  and  the 
skin  was  thick,  grey,  w^'inkled,  and  dry.  At  some  places  it  had  become 
thrown  into  thick  folds.  Only  a  few  scabs  or  crusts  had  formed  where 
the  animal  had  recently  rubbed  itself.  In  some  scurf  scraped  from  what 
seemed  to  be  the  parts  most  recently  invaded,  numbers  of  acari  were 
without  much  difficulty  found  with  the  microscope. 

A  good  many  cases  of  mange  of  undetermined  character  have  been 
reported  as  occurring  among  cattle  in  various  parts  of  England  during 
the  last  year  or  two,  and  in  a  number  of  instances  the  disease  was 
believed  to  have  been  contracted  during  exhibition   at  a  show.     It  is 


PSOROPTIC    MANGE.  639 

not  improbable  that  some  or  all  of  these  were  cases  of  this  sarcoptic 
mange,  and  in  view  of  its  very  contagious  character  it  is  desirable 
that  care  should  be  taken  to  exclude  from  shows  animals  exhibiting 
any  symptom  of  the  disease. 

PSOROPTIC     MANGE. 

This  condition  has  also  been  termed  dermatodectic  mange.  This 
is  very  rare,  and,  like  the  former,  of  trifling  clinical  importance. 

Causation.  It  is  due  to  infection  with  Psoroptes  communis  (r.  hovis). 
Poor  condition,  want  of  grooming,  bad  hygienic  surroundings  and 
general  neglect,  facilitate  its  spread. 

Symptoms.  It  commences  at  the  base  of  the  neck,  in  rarer  cases 
at  the  sides  of  the  neck,  along  the  withers,  and  at  the  root  of  the 
tail;  thence  it  gradually  attacks  the  croup,  loins,  back,  shoulders, 
sides  of  the  chest,  and  finally  all  the  body  with  the  exception  of  the 
limbs. 

It  produces  violent  itching,  the  animal  continually  scratching  itself, 
even  causing  raw  sores.  At  first  the  epidermis  is  elevated  in  little 
miliary  points,  which  may  be  isolated  or  confluent,  and  are  filled 
with  serosity.  This  fluid  discharges,  gluing  together  the  hairs ;  it 
then  hardens  and  produces  adherent  crusts,  which  increase  in  num- 
ber and  size.  The  skin  exhibits  large  numbers  of  bare,  mangy  points  ; 
these  have  irregular  margins,  and  are  covered  with  thick,  grey,  scal}^ 
crusts.     The  psoroptes  are  found  under  these  crusts. 

The  skin  becomes  hard,  dry,  fissured  and  cracked,  and  sometimes 
forms  large  folds  on  the  sides  of  the  neck,  shoulders  and  chest. 

The  influence  of  the  seasons  on  the  development  of  this  disease 
has  been  well  shown  by  Gerlach  and  MuUer.  The  disease  commences 
about  the  end  of  autumn,  when  the  animals  are  stabled.  It  continues 
to  extend  until  February,  but  diminishes  as  soon  as  the  animals  re- 
turn to  the  fields  in  spring.  The  crusts  fall,  the  hair  again  grows, 
and  the  animal  appears  to  be  cured,  but  the  disease  again  revives 
during  the  autumn.  The  psoroptes  lie  hidden  during  the  summer 
round  the  poll  and  the  horns.  The  disease  seldom  attacks  animals 
at  grass  and  in  good  condition,  or  those  over  three  years  old.  Calves, 
yearlings,  and  two-year-olds  in  poor  condition  suffer  most. 

When  the  disease  is  verj^  extensive,  the  animals  lose  condition 
and  may  even  die. 

Diagnosis.  Psoroptic  mange  in  the  ox  may  be  mistaken  for  several 
cutaneous  diseases,  to  which  it  has  a  certain  resemblance,  as  for  instance 
phthiriasis  and  the  first  stage  of  ringworm. 

These  different  diseases,  however,  show  their  own  distinctive  symp- 
toms on  a  careful  examination. 


640  SCABIES — SCAB — MANGE. 

The  prognosis  only  becomes  grave  when  the  disease  has  been 
neglected  and  the  animals  are  greatly  reduced  in  condition.  When 
recent,  this  form  of  mange  can  readily  be  cured  by  the  application 
of  parasiticides. 

Treatment.  As  in  dealing  with  all  transmissible  diseases,  the 
animals  must  be  isolated  and  washed  with  soap,  and  the  diseased 
parts  must  be  dressed  with  some  parasiticide,  such  as  sulphur  oint- 
ment. The  best  preparations  are :  Benzine  and  petroleum  in  equal 
quantities ;  concentrated  solution  of  sulphuret  of  potassium  (8 
ounces  to  the  quart)  ;  Helmerich's  ointment ;  diluted  creohn  solu- 
tion ;  decoctions  of  tobacco ;  ointment  of  pentasulphuret  of  potassium, 
and  oil  of  cevadilla. 

One  or  two  applications  are  generally  sufficient  to  effect  a  cure,  and 
relapses  are  not  likely  to  take  place  if  the  stable  is  disinfected.  In 
America  the  disease  is  common  in  the  West  and  North-West,  where 
it  is  treated  by  the  lime-and-sulphur  bath  recommended  for  sheep-scab 
(which  see).  Large  vats  are  constructed,  and  the  oxen  are  lowered  into 
these  by  means  of  a  wooden  cage  controlled  by  machinery,  which  is  ope- 
rated either  by  a  small  engine  or  more  frequently  by  a  horse. 

The  food  should  be  of  good  quality,  for  good  general  health  plays 
a  great  part  in  resisting  parasitic  invasions. 

CHORIOPTIC    MANGE. 

This  disease  has  also  been  termed  dermatophagic  and  symbiotic 
mange. 

It  was  first  described  in  1835  by  Kegelaar,  and  has  been  the  sub- 
ject of  investigation  by  Hering,  Gerlach,  Delafond,   and  Megnin. 

Causation.  It  is  produced  by  the  Chorioptes  horis,  and  is  transferred 
with  difficulty,  even  by  co-habitation. 

Symptoms.  This  form  of  mange  in  the  ox  does  not  affect  the  same 
parts  as  in  other  animals.  In  the  horse,  etc.,  it  attacks  the  limbs,  whilst 
in  the  bovine  sj^ecies  it  is  usually  found  at  the  base  of  the  tail.  It  causes 
slight  itching.  The  diseased  region  becomes  covered  ^ith  numerous 
little  pellicles,  the  hairs  gradually  fall,  crusts  form,  and  the  skin  shows 
deep  cracks.  When  the  disease  is  completely  neglected,  it  may  extend 
to  the  loins,  back,  sides  of  the  body  and  shoulders.  It  may  also  affect 
the  perineal  region,  the  inner  surface  of  the  thighs,  and  in  fact  the  whole 
of  the  body  if  the  animals  are  young  and  in  poor  condition. 

Diagnosis.  At  the  outset  it  is  difficult  to  distinguish  between  chori- 
optic  and  psoroptic  mange,  and  the  use  of  the  microscope  is  necessary. 
On  a  superficial  examination  chorioptic  mange  may  be  mistaken  for 
phthiriasis  when  the  latter  attacks  the  posterior  portions  of  the  body. 


SARCOPTIC   MANGE.  641 

particularly  the  base  of  the  tail,  and  when  it  is  accompanied  by  erup- 
tions, loss  of  hair,  and  intense  itching. 

The  distinction  between  the  two  conditions,  however,  is  extremely 
easy  after  an  examination  of  the  two  parasites. 

Prognosis.  The  disease  is  of  slight  gravity,  and  does  not  threaten 
the  animal's  health  unless  neglected  for  so  long  a  time  that  the  para- 
sites invade  all  parts  of  the  body.  In  that  case  the  disease  may 
cause  anaemia  and  loss  of  condition. 

The  treatment  of  this  form  of  mange  comprises  nothing  special,  it 
being  sufficient  to  proceed  as  directed  in  the  previous  article. 

The  stables  ought  always  to  be  thoroughly  disinfected. 

MANGE    IN    THE    GOAT. 

The  goat  suffers  from  the  attacks  of  sarcoptes,  psoroptes,  and 
chorioptes,  but  up  to  the  present  time  only  two  forms  of  mange 
have    been   described,    sarcoptic    and   chorioptic   mange. 

Psoroptes  have  only  been  found  about  the  eye,  where  the  disturb- 
ance they  produce  is  comparatively  trifling. 

SARCOPTIC    MANGE. 

This  disease  was  noticed  in  1818  in  goats  imported  into  France 
from  Thibet. 

Henderson  published  the  history  of  a  Persian  goat  which  conveyed 
sarcoptic  mange  to  men  and  horses.  In  1851  Walraff  noticed  an  epi- 
zootic mange  which  attacked  the  goats  in  the  Prattigau  valley  of 
Switzerland,  which  was  transmitted  to  men  and  sheep  and  which 
exhibited  the   clinical   characters   of   sarcoptic   mange. 

Causation.  This  disease  is  due  to  the  presence  of  Sarcoptes  scahiei 
(r.  caprce). 

It  sometimes  occurs  in  an  epizootic  form,  as  Walraff's  observations 
show,  but  it  seems  specially  to  attack  goats  in  Asia  and  Africa. 

This  mange  may  be  transmitted  by  the  goat  to  sheep,  in  which 
animals  it  attacks  the  head  and  muzzle  ;  it  is  particularly  contagious 
in  sheep  having  coarse,  dry  fleeces. 

Similarly  sarcoptic  mange  of  sheep  may  be  conveyed  to  the  goat,  in 
which  animal  it  extends  all  over  the  body. 

Symptoms.  This  mange  causes  intense  itching.  It  first  attacks  the 
head  and  ears,  then  the  trunk,  belly,  udder,  and  limbs.  If  the  disease  is 
neglected  it  becomes  generalised  very  rapidly,  and  the  animals  waste 
away  and  die  in  a  very  short  time. 

At  the  commencement  little  crusts,  which  discharge  a  viscous  liquid, 
are  found  al)out  the  head.     The  goats  rub  themselves  raw,  and,  as  in 

D.C.  T  T 


642  SCABIES — SCAB — MANGE. 

facial  mange  of  slieep,  there  ajDpear  dry,  scaly,  branlike  patches.  After 
a  time  the  diseased  area  extends,  the  wool  falls,  and  the  skin  becomes 
dry,  thick  and  wrinkled.  The  appearance  is  exactly  like  that  of  sarcoptic 
mange  in  sheep,  the  lower  part  of  the  head  being  seldom  invaded.  The 
animals  lose  condition,  waste  and  die  of  exhaustion. 

Diagnosis.  The  parasite  is  readily  recognised,  and  the  practitioner, 
moreover,  is  often  put  on  his  guard  by  the  epizootic  character  assumed 
by  the  disease. 

The  prognosis  is  grave.  Walraff  declared  the  mortality  in  Grisons 
(Switzerland)  to  be  as  high  as  20  per  cent. 

The  treatment  is  identical  with  that  of  psoroptic  mange  in  sheep. 
After  the  animals  have  been  sheared  and  washed  with  soap,  they  should 
be  completely  immersed  in  a  bath  of  the  character  mentioned  in  con- 
nection with  sheep  scab.  If  only  one  animal  is  infected,  it  may  be 
sufficient  to  dress  it  repeatedly  with  an  ointment  containing  some 
parasiticide. 

CHORIOPTIC    MANGE. 

This  form  of  mange  was  noted  by  Delafond  in  1854  at  the  Jardin  des 
Plantes  (Paris)  in  some  angora  goats,  and  by  Mollereau  in  1889.  The 
disease  studied  by  Delafond  had  invaded  both  sides  of  the  neck,  the  eyes, 
withers,  back,  loins,  and  base  of  the  tail.  It  was  characterised  by  partial 
loss  of  hair,  the  finer  hair  falling  and  the  coarser  remaining  in  position. 

In  Mollereau's  case  the  disease  was  located  in  one  of  the  hind  pas- 
terns, and  assumed  the  form  of  a  thickened  band,  which  produced  an  oede- 
matous  swelling.  The  chorioptes  were  discovered  in  a  thick  crust  formed 
by  the  drying  on  the  hair  of  the  discharge  due  to  their  punctures. 

Diagnosis.  The  parasites  can  easily  be  found  under  the  crusts,  and, 
once  recognised,  distinguish  the  disease  from  any  other  infection. 

Treatment.  Ointments  containing  some  parasiticide  and  solutions 
of  sulphu]-et  of  potassium  generally  suffice,  the  disease  having  little 
tendency  to  become  generalised. 

MANGE    IN    THE    PIG. 

The  pig  suffers  from  one  variety  only  of  mange.  It  was  described 
by  Viborg,  Gurlt  and  Spinola,  who  found  a  sarcopt  in  the  mange  of 
wild  boars  in  1847.  Hertwig  and  Gerlach  made  a  similar  observation 
some  years  later.  Delafond  in  1857  discovered  the  sarcopt  of  mange 
in  the  pig. 

Causation.  Sarcoptic  mange  in  the  pig  is  due  to  the  presence  of 
Sarcoptes  scabici  (r.  Huis),  although  the  pig  may  contract  (temporarily) 
the  sarcoptic  mange  of  goats. 

Contagion  is  favoured  by  poor  condition,  over-crowding,  dirt  and  bad 
hygienic  surroundings. 


DEMODECIC   MANGE.  643 

The  primitive  races  of  pigs  resist  the  disease  better  than  the 
improved  races.  This  mange  can  be  conveyed  to  man  and  to  other 
animals. 

Symptoms.  It  usually  commences  about  the  head,  ears,  and  eyes, 
and  extends  to  the  quarters,  internal  surface  of  the  thighs,  etc.  In  the 
early  phases  it  is  impossible  to  discover  the  little  galleries  under  the 
epidermis,  but  closely  placed  reddish  papules  may  be  seen.  The  active 
proliferation  of  the  epidermis,  together  with  discharge,  causes  the  for- 
mation of  dry  crusts  of  a  greyish-white,  silvery  tint,  adherent  while 
still  thin,  easy  to  detach  at  a  later  stage,  and  sometimes  f  of  an  inch 
in  thickness.  The  skin  becomes  wrinkled,  the  bristles  are  shed  or 
loosened  in  their  follicles,  and  are  glued  together  in  little  bunches  before 
falling.  As  these  patches  extend  over  the  whole  surface  of  the  body,  the 
animal  appears  to  be  bespattered  with  dry  guano  (Muller). 

Under  the  crusts  the  skin  is  rough,  excoriated,  and,  about  the 
thorax  and  abdomen,  is  indurated,  and  sometimes  measures  1  to  1^ 
inches  in  thickness.  In  other  parts,  particularly  at  the  base  of  the 
ears,  the  papillae  are  hypertrophied  ;  they  become  as  large  as  a  pea, 
or  even  a  bean,  and,  lifting  the  crusts  which  cover  them,  assume  the 
appearance  of  the  warts  sometimes  found  on  the  cheeks  of  dogs  or  the 
teats  of  cows.  SarcojJtes  may  be  found  under  these  epidermic  growths, 
though  in  order  to  obtain  them  the  skin  must  be  scraped  until  it  almost 
bleeds. 

The  dimensions  of  these  parasites  render  them  visible  to  the  naked 
eye.  They  are  the  largest  variety  of  the  sarcoptinte,  the  egg-bearing 
female  being  half  a  millimetre  in  length.  Guzzoni  has  found  in  the  ears 
specimens  of  smaller  size. 

Mange  in  pigs  develops  slowly.  When  it  affects  the  whole  body,  it 
l^revents  fattening  and  causes  loss  of  condition. 

Diagnosis.  This  is  the  only  parasitic  disease  which  affects  the  entire 
surface  of  the  body  and  presents  these  peculiar  powdery  crusts. 

Treatment.  All  the  styes  should  first  be  carefully  disinfected. 
Treatment  is  commenced  by  vigorously  scrubbing  the  animal  with  a 
brush  dipped  in  soap  and  water,  and  thus  getting  rid  of  the  crusts  as 
far  as  possible. 

The  animals  are  afterwards  dressed  with  decoctions  of  tobacco,  with 
Helmerich's  ointment,  or  the  other  mixtures  above  mentioned. 


DEMODECIC    MANGE. 

This  mange  is  produced  by  parasites  of  the  family  Demodecidse 
{Demodex  foUiculonnn),  which  live  in  the  hair  follicles  and  sebaceous 
glands  of  several  species  of  mammals. 

T  T    2 


644 


SCABIES — SCAB — MANGE. 


DEMODECIC    MANGE    IN    THE    OX. 

This  was  described  in  1845  by  Gros,  and  in  1878  was  found  by  Faxon 
in  Illinois  in  the  skins  of  cows  prepared  for  tanning.  It  has  not  been 
met  with  in  France.  The  skins  examined  by  Faxon  showed  numerous 
rounded  enlargements,  resulting  from  dilatation  of  the  hair  follicles  in 
the  regions  of  the  neck  and  shoulders. 

By  pressing  on  these  enlargements  a  whitish,  greasy,  sebaceous 
material  was  ejected,  very  rich  in  demodectes. 


DEMODECIC    MANGE    IN    THE    GOAT. 


This 
College, 


was  first  noticed  by  Niederhaiisern,  at  the  Bern  Veterinary 
in  a  goat  which  showed  little  nodosities  over  different  parts  of 
the  trunk,  varying  in  size  between 
that  of  a  pea  and  that  of  a  hazel- 
nut. By  forcibly  compressing  these 
enlargements  a  yellowish-grey  semi- 
solid material,  containing  a  consider- 
able number  of  demodectes,  was  caused 
to  exude. 

In  1885  Nocard  and  Piailliet  found 
the  same  parasite  in  a  young  he- 
goat  ;  the  pustules  were  spread  over 
the  sides  and  flank.  Treatment  con- 
sists in  opening  the  pustules  and 
dressing  them  a  few  times  with  an 
antiparasitic  lotion. 


Fig.  263. — Demodex  of  the  pig, 
magnified  250  diameters.  (After 
Eailliet.) 


DEMODECIC    MANGE    IN    THE    PIG. 

This  was  well  described  for  the 
first  time  by  Csokor.  It  was  after- 
wards seen  by  Neumann  and  Lindqvist. 
The  isolated  pustules  are  of  the 
size  of  a  grain  of  sand,  but  when  confluent  may  reach  the  size  of  a 
hazel-nut.  They  are  sometimes  dark  in  colour,  often  deep-seated,  are 
surrounded  by  a  zone  of  inflammation,  and  appear  in  places  where  the 
skin  is  fine  (the  groin,  neck,  belly,  etc.).  The  demodex  becomes  lodged 
and  multiplies,  not  in  the  hair  follicles,  but  in  the  sebaceous  glands. 
Csokor  regarded  this  disease  as  contagious ;  in  a  herd  of  one  hundred 
he  found  twenty-two  pigs  affected  with  it.  Lindqvist,  however,  found 
but  one  case  in  a  herd  of  two  hundred. 


NON-PSOROPTIC   FORMS   OF   ACARIASIS.  645 

NON=PSOROPTIC    FORMS    OF    ACARIASIS. 

These  are  produced  in  farm  animals  by  arachnide  belonging  to  the 
families  of  Ti'ombidiidfe  and  Ixodid£e. 

(1.)  The  Leptus  autumnalis  is  considered  to  be  the  larva  of  the 
Tromhidiuui  Ilolosericium,  or  silky  trombidion.  It  lives  in  late  summer 
and  autumn,  in  the  grass. 

Symptoms.  The  animals  show  intense  itching,  and  cannot  sleep 
owing  to  burning  sensations.  They  continually  rub  themselves,  and 
thus,  secondarily,  produce  excoriated  papules  and  patches  resembling 
those  of  eczema.  When  the  papules  are  very  numerous,  particularly 
if  the  animals  are  thin-skinned,  more  or  less  extensive  erythema  may 
be  produced. 

At  the  points  attacked  the  skin  swells,  becomes  red,  and  sometimes 
even  violet,  and  exhibits  irregular,  isolated  or  confluent  swellings,  \ 
to  f  of  an  inch  in  diameter. 

The  parasite  most  commonly  becomes  fixed  round  the  lips,  the  fore- 
head, the  cheeks,  the  sides  of  the  neck,  and  the  extremities. 

The  diagnosis  is  easy,  the  discovery  of  the  parasite  removing  all 
doubt. 

The  condition  is  of  slight  importance.  The  parasites  do  not  live  for 
more  than  a  few  days  on  the  animal's  skin,  so  that  they  only  produce 
temporary  disturbance. 

Treatment  consists  in  bathing  the  parts  with  some  lotion,  such  as  2 
to  3  per  cent,  creolin  or  2  per  cent,  chloral,  or  in  applying  mixtures 
of  oil  and  petroleum,  etc. 

(2.)  Ixodes  hexagonus,  I.  ricinus,  and  other  species  of  the  tick  family 
(Ixodidffi)  attack  sheep,  goats,  and  oxen  in  France. 

Symptoms.  In  sheep  the  ixodidae  usually  affix  themselves  at  points 
where  the  skin  is  tender  and  unprotected  by  wool,  as  for  instance  the 
thighs,  armpit,  and  upper  part  of  the  neck.  Their  bites  produce  irrita- 
tion, followed  by  an  intense  burning  sensation,  and  the  formation  of  a 
red  blush  round  the  point  bitten. 

In  the  ox  the  ticks  fasten  on  the  neck,  behind  and  within  the  ears, 
and  also  wherever  the  skin  is  tender.  Until  the  last  few  years  little 
importance  was  attached  to  their  development,  but  since  it  has  been 
proved  that  Rkipicephalus  annidatus  is  the  active  factor  in  desseminating 
Texas  fever,  ticks  have  attracted  much  attention. 

It  seems,  moreover,  to  be  proved  by  the  researches  of  Lignieres  that 
a  form  of  piroplasmosis  exists  in  France,  and  it  seems  possible  that  the 
Ixodes  )-icinns  may  be  a  means  of  propagation. 

The  diagnosis  of  acariasis  produced  by  ticks  is  easy,  for  the  para- 
sites attain  larue  dimensions. 


64G 


SCABIES — SCAB — MANGE. 


Prognosis.  It  is  difficult  at  present  to  say  what  importance  should 
be  attached  to  this  form  of  acariasis,  but  its  existence  and  possible 
consequences  should  be  noted. 

Treatment.  Some  authors  have  recommended  killing  the  ticks  by 
touching  them  with  benzine,  petroleum,  essence  of  turpentine,  etc.,  but 
these  methods  do  not  always  succeed.  Applications  of  concentrated 
solution  of  chloral  are  more  effective.  When  the  parasites  are  so  large 
as  to  render  this  possible  it  is  better  to  remove  them  by  hand,  taking 
care  at  the  same  time  to  remove  the  rostrum,  which,  if  left  in  place, 
might  cause  more  or  less  suppuration.      In  countries  where  ticks  are 


Fig.  264. — Ixodes  ricinus.     (After  Railliet.)     A,  Natural   size  ;    B,  ventral 
surface  ;  C,  dorsal  surface. 

numerous  and  large  numbers  of  cattle  are  infested,  the  parasites  are 
destroyed  by  smearing  and  dipping. 

(The  cattle  ticks  of  America  are  of  especial  importance  in  relation 
to  the  disease  known  as  Texas  fever.  Those  who  wish  to  study  the 
entomology  of  this  subject  are  referred  to  the  masterly  account  and 
fine  coloured  illustrations  of  Salmon  and  Stiles,  "  Cattle  Ticks  of  the 
United  States,"  Ann.  Eep.  U.S.A.  Bureau  of  Agriculture,  1900,  p.  380.) 


HYPODERMOSIS    IN    THE    OX    (WARBLES). 

Causation.  This  is  a  parasitic  disease  characterised  by  subcutaneous 
swellings  due  to  the  presence  of  larvae  of  the  Hypoderma  hovis.  The 
larva  is  met  with  throughout  Europe.  It  attains  the  perfect  stage 
during  the  summer,  from  the  middle  of  June  to  tlie  commencement 
of  September. 


tt^PODERMOSIS    IN    THE    OX    (WAUBLES). 


647 


The  female  dei30sits  her  eggs  on  animals  with  fine  skins.  These 
eggs  are  elliptical,  and  provided  with  a  kind  of  tail  .  of  a  brownish 
colour.  They  soon  become  converted  into  larvae,  provided  with  rows 
of  little  spines. 

The  manner  in  which  the  eggs  are  laid  is  not  exactly  understood, 
nor  are  we  better  informed  regarding  the  hatching  of  the  young  larvae. 
Until  recently  it  was  believed  that  the  larva  perforated  the  skin  as  soon 
as  it  quitted  the  egg,  and  then  penetrated  as  far  as  the  subcutaneous 
connective  tissue.  Eecent  observations,  however,  have  upset  this  view. 
It  is  probable  that  this  larva,  like  other  gastrophili,  is  swallowed  by 
animals  of  the  bovine  species,  and  passes  through  the  intestine  into 
the  surrounding  tissues  by  a  path  which  is  yet  unknown,  possibly  by 
the  blood-vessels,  whence  it  makes  its  way  after  a  longer  or  shorter 
interval  into  the  subcutaneous  connective  tissue. 

Certain  recent  observations  seem  to  support  the  latter  view,  which 


Fio 


i 


265. — A,  Hypoderma  bovis,  natural  size.    B,  larva  of  the  hypoderma 
escaping  from  a  "  warble.''     (After  Railliet.) 


is  also  corroborated  by  known  facts  regarding  hypodermic  myiosis 
in  man.  The  eggs  are  laid  in  summer,  and  the  swellings  indicating 
the  presence  of  the  larvae  only  appear  during  the  winter.  Henrichsen 
found  young  larvae  in  the  fatty  tissue  situated  between  the  periosteum 
and  spinal  dura-mater,  between  the  period  from  December  to  March. 

Symptoms.  Whatever  the  mode  of  development  of  the  larvae, 
cutaneous  swellings  appear  between  the  months  of  February  and 
March  on  the  back,  lumbar  region,  quarters,  shoulders  and  ribs,  and, 
less  frequently,  over  the  chest,  belly  and  thighs. 

They  vary  in  number.  Commonly  there  are  from  ten  to  twenty, 
and  it  is  only  in  rare  cases  that  less  than  four  or  five  are  found.  As 
soon  as  they  attain  the  subcutaneous  connective  tissue  they  act  as 
foreign  bodies,  causing  a  circumscribed  inflammation,  and  finally  sup- 
puration.    In  this  way  the  so-called  "  warbles  "  are  produced. 


648  HYPODERMOSIS. 

Each  larva  is  surrounded  by  a  thick  wall,  forming  a  cavity,  which 
communicates  with  the  outer  air  by  a  minute  aperture. 

When  the  swelling  is  sufficiently  advanced  the  larva  may  be  extri- 
cated by  pressing  with  the  fingers  around  the  base  of  the  warble.  A 
few  days  before  it  leaves  its  shelter  the  larva  enlarges  the  little  opening 
by  thrusting  its  last  rings  into  it.  Soon  after  the  larva  has  escaped 
the  discharge  of  pus  ceases,  and  the  skin  wound  heals. 

Diagnosis.  The  times  at  which  the  swellings  appear  and  the  larvae 
are  present  render  the  diagnosis  easy. 

Prognosis.  This  is  seldom  grave,  for  the  larvae  rarely  cause  death 
In  cases  where  they  are  present  in  very  large  numbers,  however,  they 
may  set  up  purulent  infection. 

Treatment.  No  really  effective  treatment  against  warbles  is  known. 
Curative  treatment  consists  in  squeezing  out  or  killing  the  larvae 
when  in  the  subcutaneous  tissue,  but  this  is  practically  useless,  as 
the  dead  larvae  then  set  up  prolonged  suppuration. 


CHAPTER    III. 
RINGWORM. 

The  old  term  "  ringworm  "  is  still  used  to  indicate  a  well-marked 
skin  disease  due  to  parasitic  fungi  which  grow  at  the  expense  of  the 
epidermis.  Other  names,  such  as  dermatophytis  and  epidermophytis, 
have  been  suggested,  to  indicate  the  mode  in  which  the  parasite 
grows.  The  term  dermatomycosis  suggests  a  cutaneous  vegetable 
parasite. 

The  dermatomycoses  of  the  domestic  animals  are  caused  by  fungi 
belonging  to  six  distinct  genera : — 

Trichophyton  (horse,  ass,  ox,  dog,  pig)  ;  Eidamella  (dog)  ;  Micro- 
sporum  (horse,  dog) ;  Achonon  (dog) ;  Lophophyton  (fowl)  ;  Oospora 
(dog). 

Eingworm  is  common  in  animals  of  the  bovine  species,  but  very 
rare  in  other  domesticated  animals,  except,  perhaps,  the  horse.  It 
is  caused  by  the  growth  of  a  parasite.  Trichophyton  mentagrophytes 
(Eobin),  of  the  genus  Trichophyton,  family  Gymnoascea,  order  Asco- 
mycetes. 

The  ascosporaceous  form  of  reproduction  is  still  unknown,  but  the 
mode  of  reproduction  by  conidia  is  characteristic.  In  cultures  the 
mycelium  is  represented  by  growing  filaments  branching  off  at  right 
angles,  and  by  separate  superficial  aerial  reproductive  filaments  of 
the  conidian  form.  There  is  some  reason  for  believing  that  these 
fungi  may  lead  a  saprophytic  as  well  as  a  parasitic  existence,  i.e., 
that  they  can  exist  and  multiply  apart  from  the  animal  body. 

Their  vitality  is  marked.  Various  experimenters  have  transmitted 
the  disease  with  crusts  kept  for  eighteen  months.  Thin  declares 
that  in  two  and  a  half  years  the  spores  had  lost  all  power  of  germi- 
nation. They  resisted  immersion  in  water  for  two  days,  but  were 
dead  after  eight  days.  Soft  soap  and  1  per  cent,  acetic  acid  kill 
them  in  an  hour. 

Symptoms.  The  disease  most  frequently  attacks  young  animals 
and  milch  cows — very  rarely  adults  or  old  animals.  This  peculiarity 
is  very  difficult  to  explain. 

In    calves,    ringworm    seems    specially    to    attack    the    head,    the 


650 


RINGWORM. 


neigbourhood  of  the  lips,  the  nostrils  and  sub-maxillai7  region,  as 
well  as  the  throat  and  neck.  It  assumes  the  form  of  circular 
patches,  over  which  the  hair  stands  erect. 

Gruby  in  1842  discovered  the  parasite  of  tinea  tonsurans,  or 
herpes,  and  thus  proved  that  the  cutaneous  lesions  were  not  due  to 
any  constitutional  condition,  as  was  long  thought,  although  dirt,  bad 
hygienic  conditions,  and  crowded  stables  favoured  the  spread  of  ring- 
worm. 

Direct  contact  between  healthy  and  diseased  animals  and  the 
transport  of  spores,  by  combs,  brushes,  etc.,  favour  contagion.  The 
disease  may  not  only  be  conveyed  from  one  animal  to  another  of  the 

same  species,  but  from  the  ox  to 
man,  and,  with  somewhat  greater 
difficulty,  from  the  ox  to  the  horse. 
Cases  of  transmission  from  the  ox 
to  the  sheep,  pig,  and  dog  have 
also  been  recorded. 

Megnin  in  1890  attempted  to 
prove  that  all  the  trichophytons  pro- 
ducing ringworm  in  animals  do  not 
belong  to  the  same  species,  and  gave 
the  name  of  Tricliophyton  epilans  to 
that  usually  found  in  the  ox,  be- 
cause it  causes  absolute  loss  of  the 
hair  by  growing  in  the  follicle,  whilst 
he  named  the  parasite  found  in  the 
horse  Trichophyton  tonsurans,  be- 
cause it  only  grows  on  the  surface 
of  the  skin  and  in  the  thickness 
of  the  hair,  without  causing  inflammation  of  the  hair  follicle  and 
without  invading  it. 

The  epidermis  soon  undergoes  proliferation,  and  becomes  covered 
with  crusts,  which  adhere  to  the  hairs,  gluing  them  together,  and 
finally  causing  them  to  be  shed,  leaving  bare  patches  the  size  of  a 
shilling  or  a  florin.  The  lesion  extends  in  an  ever- widening  circle, 
until  it  attains,  perhaps,  the  dimensions  of  a  tive-shilling  piece  or 
more. 

The  affected  hairs  break  off  level  with  the  free  surface  of  the 
skin,  rendering  the  patches  more  apparent.  White  hairs  are  less 
affected,  and  some  always  remain  projecting  above  the  crusts,  causing 
the  patches,  when  on  a  white  skin,  to  retain  a  certain  amount  of 
covering. 

At  first  the  crust  is  closely  adherent  to    the  skin,  and,  if   forcibly 


Fig.  266.— Calf  suffering  from 
ringworm. 


RINGWORM,  651 

detached,  exposes  the  dermis,  which  is  swollen  and  bleeding.  Gradu- 
ally the  centre  becomes  detached,  whilst  the  periphery,  representing 
a  more  recent  lesion,  continues  to  adhere.  The  crusts  then  rest  on 
a  thin  layer  of  pus,  and  the  dermis,  whilst  still  inflamed,  is  punc- 
tuated with  numerous  minute  apertures,  representing  the  roots  of  the 
detached  hairs.  The  pus  lifts  the  crust ;  gradually  it  dries  up  and 
forms  superposed  layers,  which  may  or  may  not  prove  adherent  to 
the  parasitic  products,  and  which  form  a  new  crust.  The  latter  is 
purely  inflammatory  in  character,  and  is  left  after  the  fall  of  the 
first.  It  no  longer  contains  any  parasites,  at  least  within  its 
deeper   layers. 

This  second  crust  dries  up  in  its  turn,  falls  away  or  breaks  up, 
leaving  a  smooth  spot,  over  which  the  hairs  again  appear,  either  at 
once,  or  at  least  after  a  short  period  of  desquamation. 

The  disease  is  accompanied  by  well-marked  pruritus,  more  marked 
at  the  commencement  and  towards  the  end  than  during  the  inter- 
mediate period,  but,  nevertheless,  much  less  acute  than  in  scabies. 

Eingworm  may  undergo  spontaneous  cure  in  from  six  weeks  to 
three  months.  It  is  more  obstinate  in  calves  than  in  adults,  and 
the  want  of  grooming  tends  to  increase  its  duration.  If  it  extends 
over  a  large  part  of  the  body  the  disease  may  seriously  afl'ect  the 
animal's  health,  and  the  cases  described  by  Macorps  prove  that  where 
pruritus  is  violent  it  seriously  afiects  the  animal's  general  condition. 

The  patches  may  finally  become  confluent  and  the  disease  extend 
over  the  whole  of  the  neck,  shoulder  and  back,  or  it  may  attack  the 
entire  body,  leaving  it  practically  hairless. 

When  the  hair  has  been  shed,  the  crusts  and  discharge  seen  at 
the  outset  disappear,  and  the  bare  spots  are  covered  with  a  scaly 
coating,  due  to  excessive  production  of  epidermic  cells. 

According  to  Gerlach,  such  crusts  are  thicker  where  the  skin  is 
black,  and  often  exhibit  a  greyish-white,  fibrous,  starchy  appearance. 
On  unpigmented  portions  of  the  skin,  which  are  usually  thinner,  the 
crust  is  less  dense,  and  is  slightly  yellowish.  Gerlach  failed  to  re- 
inoculate  the  bare  patches  of  skin  left  after  a  primary  eruption  of 
ringworm.  Where  the  hair  had  again  grown  an  eruption  could  again 
be  produced,  though  it  was  usually  of  a  feeble  character. 

In  a  second  form  of  the  disease,  the  spots  may  be  of  very  small 
dimensions.  The  hair  falls  away,  but  there  is  no  exudative  inflam- 
mation, and  no  formation  of  crusts.  In  this  second  form  the  animals 
simply  show  characteristic  circular  bare  spots  about  the  head,  neck, 
or  shoulders. 

Causation.  The  disease  is  due  to  the  growth  of  germs  on  the 
skin   of   animals   which    are   in   a    receptive    condition.     The    parasite 


652  RINGWORM. 

thereafter  develoi:)s  in  the  hairs,  the  hair  folHcles  and  the  epidermis, 
causing  lesions  which  vavy  according  to  the  species. 

At  the  present  time  three  groups  of  ringworm  are  recognised  as 
occurring  on  animals,  Trichophytic,  Microsporous,  and  Favus. 

Clinically  the  trichophytons  are  divided  into  the  T.  ectothri.r,  which 
lives  outside  the  hair,  and  both  outside  and  inside  the  hair  follicles ; 
T.  endothrix,  which  penetrates  the  thickness  of  the  hair  itself,  render- 
ing it  brittle  and  easily  destroyed;  and  T.  cndo-cctothrix,  which  both 
surrounds  and  invades  the  hair. 

The  study  of  artificial  growths  of  these  fungi  will  probably  afford 
valuable  information  on  the  above  points.  In  the  ox  the  particular 
parasite  is  invariably  the  Trichophyton  montcuirophytes,  whatever  may 
be  the  characteristics  of  the  clinical  lesion. 

In  France  ringworm  is  particularly  common  in  Auvergne  and 
Normandy,  where  hygienic  precautions  are  neglected,  but  cases  may 
also  be  found  throughout  the  country. 

After  affecting  cows  throughout  the  winter,  the  disease  often  dis- 
appears in  the  spring.  Throughout  the  winter  cows  are  kept  in  dark 
and  often  filthy  sheds,  where  the  parasite  propagates  rapidly,  whilst 
in  spring  they  are  sent  to  grass,  where  the  conditions  are  inimical  to 
contagion. 

Diagnosis.  The  diagnosis  of  ringworm  seldom  presents  any  diffi- 
culty. The  appearance  of  the  lesions  (Fig.  266),  their  {particular  ten- 
dency to  spread  and  contagious  character,  facilitate  the  diagnosis. 
They  entirely  differ  from  those  of  eczema  or  mange,  and  should  any 
doubt  exist,  the  slightest  microscopic  examination  is  sufficient  to  dis- 
sipate it.  In  ringworm  in  the  ox  the  base  of  the  hairs  is  covered 
with  enormous  numbers  of  spore  chains,  which  do  not  extend  into  the 
depths. 

To  detect  the  parasites  it  is  best  to  shave  off  a  thin  fragment  of 
skin  from  the  periphery  of  the  patch,  place  it  on  a  slide  with  a  drop 
or  two  of  30  per  cent,  caustic  potash  solution,  and  heat  it  for  a  few 
seconds  almost  to  boiling  point.  By  applying  a  cover  glass  with 
firm  pressure  the  epidermal  cells  are  spread  out  and  the  parasites  can 
be  seen,  especially  around  the  roots  of  the  hairs.  Sometimes  they 
form  little  dirty-yellow  masses,  consisting  almost  exclusively  of  spores. 

When  ringworm  has  attacked  the  entire  surface  of  the  body,  it  is 
much  more  difficult  to  distinguish  from  sebaceous  eczema,  and  a 
microscopic  examination  or  experimental  inoculation  ma}^  become 
necessary.  Inoculation  with  ringworm  material  always  succeeds 
with  calves. 

Prognosis.  Eingworm  is  not  dangerous  in  itself.  In  time  it  may 
disappear  spontaneously,  but  when  it  extends  over  the  whole  body  it 


RINGWORM    IN    THE    SHEEP,    GOAT,    AND    PIG.  653 

may  be  dangerous.  Owing  to  their  bare  condition  the  animals  easily 
catch  cold,  while  the  epidermic  proliferation  is  very  great,  and  makes 
great  demands  on  the  animal's  bodily  powers.  Under  such  circum- 
stances it  is  better  to  slaughter  early. 

Spontaneous  recovery  from  small  lesions  may  occur  in  two  or 
three  months. 

Treatment.  The  patients  should  be  isolated,  and  any  brushes, 
combs,  etc.,  with  which  they  have  been  in  contact  must  be  dis- 
infected. 

The  diseased  areas  should  then  be  dressed  with  some  fatty  sub- 
stance, to  soften  the  crusts  and  enable  them  to  be  removed  without 
injury. 

Dressings  are  useless  unless  these  crusts  have  been  removed,  for 
the  spores  are  always  in  the  deepest  recesses  and  in  the  follicles,  so 
that  the  drugs  employed  never  come  in  contact  with  them. 

Once  the  skin  is  cleansed,  numerous  chemical  substances  may  be 
utilised,  the  solutions  being  applied  for  several  days  in  succession. 
Amongst  them  may  be  mentioned  tincture  of  iodine,  oil  of  cade, 
10  per  cent,  solution  of  sulphate  of  iron,  and  solution  of  perchloride 
of  iron.  Such  drugs,  however,  must  not  be  used  for  a  long  time,  as 
the}^  all  attack  the  skin  to  some  extent. 

When  the  patches  are  small  and  well  defined  the  following  mixture 
proves  very  efficacious  : — 

Crystallised  carbolic  acid         . .  . .  . .  . .    \ 

Tincture  of  iodine         .  .  . .  . .  . .  . .    >   Equal  parts. 

Chlorale  hydrate  .  .  .  .  .  .  . .  / 

Two  or  three  applications  generally  prove  successful.    . 

Despite  the  natural  activity  of  the  spores,  which  are  capable  of 
germination  after  three  months'  desiccation,  some  medicines  are  use- 
ful, although  it  is  necessary,  in  order  to  judge  of  their  effects,  to 
wait  for  the  renewal  of  the  skin,  hair  follicles,  and  hair. 

Where  the  disease  is  generalised  this  form  of  treatment  is  scarcely 
practicable,  or  at  least  it  becomes  more  difficult. 

Nevertheless,  by  dressing  with  soft  soap  the  disease  may  be  cured 
in  a  few  months.  The  soap  should  remain  on  the  skin  for  some 
hours  and  then  be  washed  off,  after  which  dressings  of  creolin,  lysol, 
or  chloral  solution,  etc.,  should  be  employed. 


RINGWORM    IN    THE    SHEEP,    GOAT,    AND    PIG. 

Little  information  regarding  the  dermatomycoses  of  the  sheep,  goat, 
and   pig   is  available.      Allowing  for  modifications  due  to  the  nature 


654  RINGWORM, 

of  the  coat,  tlie  symptoms  of  recorded  cases  seem  to  indicate  a  close 
relationship  with  ringworm  in  the  horse  and  ox. 

In  sheep  suffering  from  ringworm,  the  wool  is  at  first  matted  into 
small  irregular  tufts,  which  grow  larger  and  more  numerous.  The 
coat  appears  felted  together  at  various  points.  The  neck,  chest, 
shoulders  and  hack  exhibit  crustaceous  patches  covered  with  hran- 
like  epidermal  scales,  and  the  animals  suffer  from  marked  pruritus, 
which  causes  them  to  rub  and  injure  the  coat. 

Ringworm  is  very  obstinate  in  the  goat. 

Two  pigs  described  by  Siedamgrotzky  showed  irregular,  rounded 
patches,  due  to  trichophyton,  from  1  inch  to  2  inches  in  diameter, 
reddish  in  tint,  without  exudation,  but  covered  with  abundant  scales. 

In  the  pig  ringworm  attacks  the  croup,  sides  of  the  chest,  flanks 
and  sides  of  the  abdomen,  but  is  commonest  on  the  back  and  out- 
side of  the  quarters.  It  forms  red  isolated  patches,  from  1  to  2 
inches  in  diameter,  covered  with  miliary  vesicles,  which  in  turn  are 
replaced  by  brown  crusts.  The  bristles  remain  unchanged,  and  are 
not  shed  or  broken.  There  is  no  pruritus.  Contagion  from  pig  to 
pig  occurs  readily.  The  disease  may  be  conveyed  from  oxen  to  pigs 
through  the  medium  of  litter  removed  from  the  cowsheds  to  the 
piggery. 

Gerlach  was  unable  to  inoculate  sheep  or  pigs  with  ringworm  from 
the  ox.  Perroncito  mentions  a  case  of  contagion  from  the  ox  to  a 
lamb.  Schindelka  has  seen  sheep  contract  ringworm  as  a  result  of 
confinement  to  sheds  previously  occupied  by  oxen  suffering  from  the 
disease. 

Siedamgrotzky  successfully  inoculated  two  pigs  and  two  sheep  with 
ringworm  from  the  horse  and  a  goat  with  the  bovine  form  of  the 
disease.  The  two  pigs  inoculated  two  others  by  contact.  Contagion 
from  the  goat  to  the  ox  was  noted  in  the  canton  of   Ziirich  in  1852. 

Fuller  particulars  on  these  heads  will  be  found  in  a  series  of  articles 
by  Neumann  in  the  Revue  Veterinaire,  January  to  June,  1905. 

In  1876  Laillier  communicated  to  a  French  medical  society  a 
letter  written  by  Lespiau  describing  an  endemic  of  trichophyton  dis- 
ease in  the  cantons  of  Ceret  and  Arles-sur-Tech.  Thirty-four  per- 
sons, including  twenty-eight  children,  were  affected.  A  dog  was  first 
attacked  and  seems  to  have  inoculated  a  pig,  which  in  these  districts 
often  lives  with  the  human  family.  The  pig  inoculated  the  human 
beings.  A  moist  season  appears  to  have  favoured  the  development 
of  the  disease.  The  parts  principally  attacked  were  the  head,  eye- 
brows, cheeks,  and  neighbourhood  of  the  genital  organs.  The  sub- 
jects showed  considerable  pruritus. 


CHAPTER    IV. 
WARTS    IN    OXEN. 

Warts  are  cutaneous  tumours,  real  papillomata,  which  most  com- 
monly attack  young  animals  such  as  heifers.  As  a  rule  they  are 
pedunculated,  smooth,  wrinkled  or  deeply  cracked  on  the  surface,  but 
in  some  cases  they  are  sessile. 

Causation.  The  cause  is  difficult  to  ascertain.  It  has  been  referred 
to  the  growth  of  bacteria  (Bacterium  jiorri)  in  the  superficial  layers 
of  the  skin.  It  is  at  least  certain  that  warts  can  be  transmitted  by 
inoculation  or  through  the  medium  of  cutaneous  injuries. 

Symptoms.  On  their  first  appearance  warts  consist  in  hypertrophy 
of  the  cutaneous  papillae,  which  become  covered  with  layers  of  actively 
growing  epidermis  and  end  by  projecting  above  the  general  surface. 
The  lesions  may  remain  isolated,  or  they  may  become  confluent  or 
unite  at  their  base.  This  form  is  fairly  common,  the  warts  attaining 
the  size  of  a  man's  fist  or  more. 

The  disease  attacks  the  most  tender  portions  of  the  skin,  such  as 
that  covering  the  udder,  internal  surface  of  the  thighs,  lower  abdo- 
minal wall,  region  of  the  elbow,  posterior  surface  of  the  ears,  etc. 
In  rarer  cases  warts  may  be  seen  on  the  limbs. 

When  they  extend  over  a  considerable  surface  they  become  in- 
fected, suppurate  and  give  rise  to  various  complications,  the  most 
serious  being  pyaemia.     The  patients  lose  condition  and  value. 

Diagnosis.  The  diagnosis  is  easy.  It  has  been  proved  that  warts 
are  contagious,  not  only  as  between  animal  and  animal,  but  as 
between  animal  and  man. 

Prognosis.  Warts  are  not  dangerous  to  life,  but  they  diminish 
the  value  of  the  animals,  particularly  that  of  milch  cows  when  the 
teats  are  affected. 

Treatment.  Leaving  out  of  account  internal  medication  with  cal- 
cined magnesia,  many  medicines  that  are  still  recommended  are  of 
comparatively  little  value. 

Peuch  and  Cruzel  recommend  friction  with  oil  of  cade.  Piepeated 
cauterisation  with  nitric  acid  is  declared  to  give  good  results  by  de- 
stroying the  new  tissue. 


656  WARTS   IN   OXEN. 

These  modes  of  treatment,  however,  are  impracticable  in  dealing 
with  large  multii)le  lesions,  nor  does  the  elastic  ligatm-e  give  much 
better  results. 

Total  removal  with  the  scissors  or  bistoury,  or  simply  tearing  out 
by  hand,  is  preferable  to  any  other  course.  Troublesome  bleeding 
may  follow,  but  is  rarely  of  great  importance.  It  usually  stops  in 
a  few  minutes,  even  where  small  arteries  of  the  size  of  several  milli- 
metres in  diameter  have  been  divided.  As  a  measure  of  precaution, 
however,  the  little  wounds  may  be  touched  with  the  red-hot  blade  of 
the  thermo-cautery. 

The  ccrascur  is  rarely  required.  The  smaller  warts  are  generally 
sessile,  and  can  be  removed  with  a  bistoury  or  a  sharp  curette.     The 


Fig.  267. 

removal  of  those  about  the  udder  requires  considerable  precaution  to 
avoid  injuring  the  teats. 

All  the  growths  are  usually  removed  at  one  operation ;  Moussu 
has  tlius  taken  away  30  lbs.  weight  without  the  slightest  ill-effect. 
After  the  wounds  have  been  washed  with  an  antiseptic,  the  raw  sur- 
faces are  powdered  with  a  mixture  of  equal  parts  of  boric  acid,  tannin, 
and  calcined  alum ;   cicatrisation  occurs  in  a  few  days. 

URTICARIA    IN    THE    PIG. 

This  disease  usually  attacks  pigs  during  the  spring  or  summer, 
producing   characteristic  cutaneous  lesions,  which,  however,  are   of   a 


SCLERODERMA.  657 

benign  character.  It  seems  to  arise  from  some  form  of  alimentary 
intoxication. 

Symptoms.  At  first  the  dominant  symptoms  point  to  disturbance 
of  digestion.  The  appetite  is  lost,  and  the  bowels  may  be  confined  or 
there  may  be  diarrhoea.  This  is  sometimes  accompanied  by  vomit- 
ing, and  by  fever. 

The  symptoms  may  develop  fully  in  from  six  to  twelve  hours ; 
sometimes  the  skin  is  covered  with  slightly  prominent  reddish 
patches,  varying  in  size  from  J  of  an  inch  to  1^  inches  in 
diameter. 

The  patches  may  also  become  confluent  and  form  large,  irregular 
red  or  violet  flattened  swellings,  sensitive  to  the  touch  and  spread 
over  the  upper  and  lateral  portions  of  the  body.  Only  in  exceptional 
cases  is  there  any  oozing  of  blood. 

In  favourable  cases  recovery  takes  place  in  forty-eight  hours,  and 
even  in  grave  cases  in  from  five  to  six  days. 

Diagnosis.  It  is  sometimes  very  difficult  to  distinguish  this  condi- 
tion from  swine  erysipelas,  particularly  in  the  first  few  cases,  although 
the  congested  or  hemorrhagic  patches  occupy  different  positions. 

The  prognosis  is  usually  favourable. 

Treatment.  The  disease  being  unquestionably  of  digestive  origin, 
the  animals  should  be  kept  without  food  and  receive  repeated  doses 
of  mild  purgatives  according  to  their  age  and  condition,  sulphate  of 
soda,  4  to  12  drachms,  or  calomel,  1^  to  '8  grains.  Kecovery  is 
rapid. 

SCLERODERMA. 

This  term  is  applied  to  a  disease  characterised  by  thickening  and 
hardening  of  the  skin.  Up  to  now  it  has  been  described  only  in  the 
pig,  and  principally  in  male  animals  or  old  animals  of  either  sex. 

The  symptoms  are  difficult  to  detect,  and  in  many  cases  are  only 
discovered  after  slaughter.  Without  any  change  in  external  appear- 
ance, the  skin  becomes  thick,  hard  and  sclerosed  over  limited  or 
extensive  areas,  and  is  thus  transformed  into  hard,  rigid,  inextensible 
and  inelastic  plates,  sometimes  as  much  as  1  to  2  inches  in  thick- 
ness. The  change  usually  commences  about  the  dorsal  region,  and  ex- 
tends irregularly  towards  the  chest  and  sometimes  towards  the  limbs. 

The  patient  thus  becomes  imprisoned  in  a  kind  of  cuirass,  which 
interferes  with  its  movements  and  causes  unaccountable  stiffness. 
Palpation  of  the  skin  gives  the  impression  of  a  piece  of  wood,  for 
it  is  hard  and  resistant  over  the  affected  regions,  whilst  over  the 
belly,  inner  surface  of  the  thighs,  and  region  of  the  elbow,  it  retains 
its  usual  pliability. 

D.c.  u  u 


658  SCLERODERMA. 

The  patient  exhibits  no  other  sjanptoms,  the  principal  functions 
of  the  body  appearing  to  be  properly  performed.  There  is  no  fever, 
but  in  time  the  animals  lose  condition  and  waste  asvay. 

Causation.  This  disease  is  also  well  known  in  man,  but  no 
general  agreement  exists  regarding  its  nature.  Some  refer  it  to  dis- 
turbance of  the  thyroideal  function,  though  scleroderma  is  quite 
different  to  myxcedema.  Others  attribute  it  to  changes  in  the  cuta- 
neous blood-vessels,  others,  again,  to  peripheral  neuritis  accompanied 
by  atrophic  disturbance.     Nothing,  however,  is  proved. 

The  apparent  lesions  are  limited  to  hypertrophic  sclerosis  of  the 
dermis,  with  progressive  atrophy  of  the  layers  of  subcutaneous  adipose 
tissue. 

The  diagnosis  is  comparatively  easy. 

The  prognosis  is  grave,  because  it  is  never  known  how  rapidly 
the  disease  may  develop. 

No  method  of  treatment  being  known,  the  animals  should  at  once 
be  slaughtered. 


CHAPTER  V. 
SUBCUTANEOUS  EMPHYSEMA. 

By  subcutaneous  emphysema  is  meant  the  condition  produced  by 
the  entrance  of  air  or  gas  into  the  subcutaneous  and  interstitial  con- 
nective tissue.  Emphysema  may  remain  locahsed  or  it  may  become 
generahsed,  according  to  the  nature  and  extent  of  the  lesion  which 
causes  it,  and  the  points  where  emphysema  is  developed.  Subcu- 
taneous emphysema  is  common  in  the  sheep  and  ox. 

Symptoms.  Sometimes  the  symptoms  of  subcutaneous  emphysema 
are  extremely  well  defined.  They  consist  in  the  presence  of  diffuse  or 
limited  crepitant  swellings  which  may  appear  at  various  points — in  the 
flank  or  the  entrance  to  the  chest ;  more  rarely  in  the  region  of  the 
elbow,  etc. 

The  limits  of  crepitation  may  be  ascertained  by  palpation,  while 
percussion  produces  a  peculiar  abnormal  sound.  The  subcutaneous 
tissue  and  very  often  the  interstitial  tissue  appear  as  though 
blown  out. 

Emphysema  may  be  generalised.  Such  an  accident  is  rare,  but 
may  occur  in  the  ox  as  well  as  in  the  sheep  and  goat. 

Provided  the  emphysema  remains  confined  to  the  subcutaneous 
tissue,  the  animals  are  not  necessarily  in  danger.  Where,  however, 
it  also  extends  to  the  interstitial  tissue,  and  particularly  if  the  cause 
to  which  it  is  due  continues,  death  may  result  in  a  very  short  time. 
This  occurs,  for  example,  when  the  emphysema  extends  into  the 
mediastinum,  and  thus  gains  the  pleura  and  lung. 

The  symptoms  of  emphysema  are  then  complicated  with  respira- 
tory and  circulatory  disturbance  and  with  signs  of  asphyxia. 

Causation.  Subcutaneous  emphysema  may  be  produced  in  many 
difl'erent  ways. 

If,  for  example,  in  puncturing  the  rumen  the  canula  be  carelessly 
withdrawn  so  that  the  skin  is  slightly  separated  from  the  subjacent 
tissues,  gas  may  pass  from  the  rumen  into  the  channel  produced  by 
the  instrument.  It  then  becomes  distributed  throughout  the  sub- 
cutaneous tissue,  and  if  the^cutaneous  opening  is  displaced  its  escape 
is  confined  to  the  connective  and  interstitial  tissues  in  the  region  of 

u  u  2 


660  SUBCUTANEOUS  EMPHYSEMA. 

the  flank.  Diffuse  suppuration  may  then  be  set  up  in  these  parts, 
and  may  extend  far  bej'ond  them. 

In  the  ox  emphysema  rarely  becomes  generalised,  but  in  the  sheep 
and  goat  extension  is  more  common  ;  the  patients  perish  of  intoxi- 
cation, caused  by  reabsorption  of  septic  gases. 

Under  other  circumstances  emphysema  may  be  due  to  an  injury 
in  some  region  where  the  connective  tissue  is  loose  and  pliable,  as  for 
instance  the  region  of  the  elbow,  the  internal  surface  of  the  shoulder, 
or  the  fold  of  the  flank.  Every  time  the  animals  move  the  tissues 
are  displaced,  and  air  being  drawn  in,  it  is  imprisoned  by  the  valve- 
like action  of  the  injured  part  and  gradually  finds  its  way  into  the 
subcutaneous  tissue. 

Accidental  injuries  to  the  trachea,  particularly  injuries  produced  by 
dogs  biting  sheep  or  goats,  are  always  accompanied  by  local  emphy- 
sema, unless  the  wounds  in  the  skin  and  trachea  correspond,  which 
rarely  happens.  At  every  respiration  a  portion  of  the  air  expelled 
passes  into  the  peritracheal  tissue,  from  which  it  gradually  invades 
neighbouring  parts,  and  may  attain  the  mediastinum,  etc.  The 
injured  animal  thus  inflates  its  own  tissues  and  dies  from  asphyxia. 

The  open  lesions  due  to  pulmonary  echinococcosis,  and  the  acci- 
dents associated  with  pneumo-thorax,  tuberculous  caverns  and  abscesses, 
or  pulmonary  emphysema  may  become  points  of  departure  for  local, 
general,  interstitial  or  subcutaneous  emphysema. 

The  diagnosis  of  accidental  emphysema  presents  no  difficulty,  for 
the  local  swellings  can  only  be  mistaken  for  those  of  blackquarter. 
In  the  latter  disease,  however,  fever  is  a  constant  accompaniment, 
whilst  in  simple  emphysema  it  is  absent. 

Nevertheless,  it  is  well  to  remember  the  possibility  of  complications 
due  to  compression,  asphyxia,  and  even  intoxication. 

The  prognosis  may  be  very  hopeful  or  very  grave.  Everything 
depends  on  the  primary  lesion,  and  it  is  therefore  important  that  the 
practitioner  should  know  how  to  interpret  the  course  of  affairs. 

Treatment.  In  slight  cases  the  best  method  is  to  immobilise  the 
parts  and  await  developments,  but  in  grave  cases,  for  instance  where 
the  trachea  is  much  injured,  the  animal  should  at  once  be  slaughtered. 

Scarification,  cutaneous  incisions,  and  massage  were  formerly 
recommended  as  a  means  of  aiding  the  escape  of  gas  accumulated 
in  the  tissues.  Such  methods,  however,  are  useless,  and  have  the 
disadvantage  of  causing  numerous  suppurating  wounds. 

Provided  the  initial  wounds  are  not  seriously  infected  and  the 
animals  are  kejDt  quiet,  in  a  well-ventilated  place,  the  gas  gradually 
becomes  reabsorbed,  and  healing  may  take  place  in  a  fortnight  or 
three  weeks. 


SECTION   IX. 
DISEASES    OF    THE    EYES. 

In  domesticated  animals,  apart  from  parasitic  diseases,  the  diseases 
of  the  eye  which  particularly  deserve  description  and  offer  a  special 
clinical  interest  are  very  few.  These  are  the  diseases  that  affect  the 
globe  of  the  eye  or  the  organs  annexed  to  it. 

FOREIGN    BODIES. 

Foreign  bodies  become  lodged  on  the  internal  surface  of  the  eyelids, 
in  the  folds  of  the  conjunctiva,  in  the  thickness  of  the  cornea,  and  some- 
times, though  rarely,  in  the  anterior  chamber,  the  lens,  or  the  vitreous 
humour.  They  include  particles  of  grit  or  dust,  the  awns  and  glumes 
of  grain,  etc. 

The  eyes  are  half  closed  and  the  conjunctiva  is  swollen,  whilst  the 
eye  weeps  and  the  animals  dread  the  light. 

Diagnosis.  This  is  somewhat  difficult,  for  the  parts  rapidly  become 
very  sensitive,  and  the  animals  violently  resist  examination.  When  the 
foreign  body  penetrates  the  anterior  chamber  or  the  lens,  it  produces 
suppuration  or  traumatic  cataract. 

Before  anything  can  be  done  it  is  often  necessary  to  render  the 
parts  anaesthetic  by  instilling  a  few  drops  of  cocaine  solution  into 
the  eye. 

The  foreign  body  may  then  be  discovered  by  close  observation. 
If  the  pain  is  very  intense,  and  great  resistance  is  offered  to  opening 
the  eye,  the  practitioner  may  confine  himself  to  passing  a  soft  camel- 
hair  brush  saturated  with  cocaine  solution  over  the  surface  of  the 
eye  and  into  the  conjunctival  sacs.  The  brush  loosens,  and  often 
removes,  the  offending  body.  In  the  absence  of  a  camel-hair  brush, 
the  little  finger,  covered  with  a  piece  of  fine  linen,  may  be  used. 

Where  the  parts  cannot  be  touched  owing  to  the  resistance  of  the 
animal,  lukewarm  solutions  of  antiseptics  such  as  boric  acid  may  be 
occasionally  injected  into  the  eye  by  means  of  a  syringe,  but  care 
must  be  taken  to  prevent  the  animal  injuring  itself  against  the 
syringe  by  sudden  movements. 


G62  DISEASES   OF   THE   EYES. 

CONJUNCTIVITIS    AND    KERATITIS. 

Inflammation  of  the  conjunctiva  and  inflammation  of  the  cornea 
ahnost  always  occur  together,  and  reciprocally  induce  one  another 
when  of  a  certain  degree  of  intensity.  They  may  he  simple,  that  is 
to  say,  produced  hy  simple  causes,  or  they  may  be  specific,  and 
of  a  contagious  character. 

Simple  inflammation  is  caused  by  the  action  of  cold,  draughts, 
dust,  or  mechanical  injuries.  Specific  inflammations,  the  nature  of 
which  is  still  little  understood,  occur  in  the  ox  and  goat.  They  are 
very  contagious,  and  may  successively  attack  all  the  animals  of  a 
herd. 

The  symptoms  of  acute  and  specific  inflammation  differ  very  little. 
They  comprise  congestion,  lachrymation,  chemosis,  a  certain  amount 
of  suppuration,  and  sometimes  superficial  ulceration  of  the  cornea. 
The  patients  suffer  very  acute  pain,  avoid  the  light,  present  all  the 
symptoms  of  photophobia,  and  are  affected  with  spasm  of  the 
orbicularis  muscle. 

In  simple  cases  these  symptoms  frequently  disappear,  provided 
the  byres  are  kept  clean  and  astringent  eye-washes  are  applied. 

In  contagious  keratitis,  however,  the  cornea  may  suppurate  and 
even  become  perforated  after  a  few  weeks. 

Treatment.  The  chief  object  of  treatment  under  any  circumstances 
must  be  to  insure  the  most  perfect  cleanliness  both  of  the  globe  of  the 
eye  and  the  conjunctival  sacs. 

The  eye  must,  therefore,  be  irrigated  wdth  lukewarm  water,  the 
stream  being  injected  beneath  the  lids.  Each  irrigation  is  followed 
by  the  use  of  an  anodyne  and  astringent  eye-wash  containing  borate 
of  soda  or  sulphate  of  zinc,  combined  if  necessary  with  cocaine. 

Distilled  water  .  .  .  .  .  .  .  .  .  .  .  .     100  parts. 

Borate  of  soda  .  .  .  .  . .  .  .         4      ,, 

Hydrochlorate  of  cocaine     .  .  . .  .  .  .  .  . .         1      ,, 

But  saturated  solution  of  boric  acid  is  simple,  and  no  less  effective. 

In  contagious  keratitis  the  eye  lotion  may  contain  2  to  3  per 
cent,  of  nitrate  of  silver,  the  excess  of  silver  being  neutralised  by 
washing  out  with  a  weak  solution  of  common  salt.  After  three  or 
four  applications  this  should  be  changed  for  a  saturated  solution  of 
boric  acid. 

VERMINOUS    CONJUNCTIVITIS. 

This  form  of  conjunctivitis,  described  by  Eodes  in  1819,  is  due  to 
the  presence  of  the  Filaria  lacJirynialis,  which  varies  in  length  between 
i  of  an  inch  and  1  inch. 


VERMINOUS  OPHTHALMIA  OF  THE  OX.  663 

Like  ophthalmia,  the  disease  attacks  cattle  reared  in  wet  localities. 

Symptoms.  The  symptoms  are  those  of  acute  conjunctivitis,  and 
consist  first  of  lachrymation,  then  of  injection  of  the  blood-vessels  of 
the  conjunctiva,  together  with  swelling  of  the  eyelids  and  photophobia. 
The  animals  keep  the  eye  closed,  and  display  extreme  sensitiveness. 
Here  again  cocaine  proves  of  value. 

Examination  is  rather  difficult,  the  worms  being  sometimes  dis- 
placed towards  the  cornea  or  membrana  nictitans,  although  more 
commonly  they  remain  hidden  in  the  folds  of  the  mucous  membrane 
towards  the  point  where  the  membrana  nictitans  is  inserted.  It  is, 
therefore,  necessary  to  thoroughly  expose  the  folds  of  the  mucous 
membrane  in  order  to  discover  them. 

In  time  conjunctivitis  becomes  complicated  with  diffuse  ulceration, 
keratitis,  and  sometimes  with  ophthalmia  and  suppuration  of  the  eye. 

Diagnosis.  The  diagnosis  is  rather  troublesome,  and  cocaine  is  of 
great  assistance. 

Prognosis.     This  is  rather  grave. 

Treatment.  The  object  of  treatment  is  the  complete  removal  of 
the  parasites.  This  can  sometimes  be  attained  by  means  of  the  finger, 
a  pair  of  forceps,  or  a  very  clean  feather. 

Treatment  is  completed  by  injecting  an  antiseptic  and  anti- 
parasitic eye  lotion  for  several  days,  lest  some  of  the  worms  should 
remain  hidden  in  the  folds  of  the  mucous  membrane.  One  per 
cent,  creolin  or  1  in  2,000  sublimate  solution  may  be  used. 

If  in  some  exceptional  case  it  is  difficult  to  remove  the  parasites, 
they  may  be  got  rid  of  by  injections  or  free  irrigation.  The  stream 
of  liquid,  pointed  in  different  directions,  distends  the  mucous  mem- 
brane and  washes  away  the  foreign  bodies  on  its  surface. 

VERMINOUS    OPHTHALMIA    OF    THE    OX. 

This  ophthalmia  is  due  to  the  presence  of  a  small  worm,  f  of  an 
inch  to  11  inches  in  length,  which  has  been  regarded  as  the  larval 
form  of  the  Filaria  cervina  of  the  serous  cavities. 

It  is  very  common  in  animals  which  are  kept  permanently  in  low- 
lying  meadows  particularly  in  some  parts  of  France,  as  for  instance 
in  Normandy,  in  the  departments  of  the  Sarthe  and  the  Mayenne. 
Not  infrequently  it  occurs  as  an  epizootic,  and  is  then  regarded  as 
a  contagious  ophthalmia.  Verminous  ophthalmia  occurs  chiefly 
during  the  spring  and  autumn. 

Symptoms.  The  disease  is  accompanied  by  lachrymation,  signs 
of  conjunctivitis,  and  fear  of  light.  Very  soon  the  media  of  the  eye 
become  turbid,  the  sclerotic  and  cornea  are  injected,  and  finally 
exhibit  marked  opalescence. 


664  DISEASES    OF   THE   EYES. 

On  examination  the  eye  appears  extremely  sensitive ;  in  fact,  it 
can  scarcely  be  touched  unless  cocaine  solution  is  previously  applied. 

The  parasites,  two  or  three  as  a  rule,  but  in  exceptional  cases 
from  five  to  seven  in  number,  are  seen  rolled  up  within  the  anterior 
chamber  of  the  eye.  A  week  after  the  beginninjT  of  the  attack,  how- 
ever, they  begin  to  move  about,  and  are  then  found  close  behind  the 
cornea,  upon  the  lens,  or  suspended  in  the  aqueous  humour. 

The  irritation  produced  sets  up  inflammation  of  Descemet's  mem- 
brane and  the  cornea,  together  with  iritis,  and,  secondly,  keratitis 
and  changes  in  the  lens. 

Unless  treatment  is  adopted  verminous  ophthalmia  inevitably 
ends  in  cataract. 

Diagnosis.  Diagnosis  is  always  uncertain  on  account  of  the  diffi- 
culty of  examination.  When  the  cornea  is  very  opaque  examination 
necessarily  gives  a  negative  result. 

The  prognosis  is  grave. 

Treatment.  Eye  lotions  containing  tincture  of  aloes,  creolin, 
corrosive  sublimate,  etc.,  have  been  suggested,  but  are  practically 
useless,  because  they  can  have  no  action  on  a  parasite  enclosed 
within  the  globe  of  the  eye.  The  most  logical  treatment  consists  in 
aseptic  puncture  of  the  anterior  chamber  of  the  eye  towards  its  lower 
border  with  a  cataract  needle. 

The  escai^ing  liquid  carries  with  it  the  parasites,  and  recovery  is 
then  only  a  matter  of  time,  provided  the  wound  does  not  become 
inflamed.  The  great  danger  consists  in  inflammation  and  suppura- 
tion of  the  eye.  This,  however,  can  be  avoided  by  antisepsis  and  by 
applying  a  surgical  wool  dressing,  which  can  be  left  in  place  for  a 
few  days. 


SECTION.  X. 
INFECTIOUS    DISEASES. 

COW-POX- VACCINIA. 

The  name  cow-pox,  or  vaccinia,  is  employed  to  describe  a  special 
disease  which  in  animals  of  the  bovine  species  is  characterised  by 
the  development  of  pustules  at  points  where  the  skin  is  fine,  and 
more  particularly  the  mammary  region. 

It  can  be  conveyed  both  to  man  and  the  domestic  animals. 

This  disease  has  been  known  from  time  immemorial,  and  it  would 
appear  that  first  of  all  in  the  East  and  later  in  England  it  was  a 
general  belief  that  its  attacks  rendered  human  beings  proof  against 
small-pox.  Medical  men,  it  must  be  admitted,  long  regarded  this 
belief  as  a  popular  delusion,  as  is  proved  by  their  continuing  to 
practise  inoculation  with  true  small-pox  material. 

Jenner  in  1770  was  the  first  to  declare  the  truth  of  this  popular 
opinion,  and  by  his  wise  foresight  to  confer  on  humanity  one  of  the 
most  beneficent  discoveries  ever  made,  although  the  weight  of  modern 
opinion  is  in  favour  of  the  identity  of  cow-pox  and  human  variola. 
Having  observed  that  milkmaids  who  happened  to  have  small  cuts 
or  sores  about  the  hands  sometimes  contracted  the  disease  in  a  mild 
form,  and  that  they  did  not  afterwards  suffer  from  small-pox,  he  was 
struck  with  the  advantages  consequent  on  such  a  discovery,  and  having 
proved  the  possibility  of  inoculating  human  beings  artificially,  he 
immediately  formulated  the  principles  of  vaccination.  A  child  eight 
years  of  age  was  vaccinated  with  cow-pox,  and  afterwards  inoculated 
with  pus  from  a  small-pox  patient.  It  contracted  vaccinia  in  con- 
sequence of  the  first  inoculation,  but  entirely  resisted  the  attempt  to 
inoculate  it  with  small-pox.     Vaccination  had  been  discovered. 

Jenner  furthermore  proved  that  cow-pox  was  transmissible  from 
cow  to  cow  and  from  man  to  man,  but  it  seemed  to  him  that  the 
original  disease  was  to  be  sought  elsewhere,  and  that  the  pustular 
affection  originated  primarily  with  the  horse.  The  horse  is  some- 
times the  subject  of  a  pustular  disease  called  horse-pox;  this  disease 
when  inoculated  in  man  confers  immunity  against  small-pox,  just  as 
does   cow-pox,  and    Jenner   believed   that   the   disease   did   not   attack 


666  INFECTIOUS   DISEASES. 

COWS  unless  they  had  been  accidentally  inoculated  through  the  medium 
of  the  people  about  the  farm.  Unfortunately,  he  named  the  pustular 
disease  of  the  horse  which  he  had  studied  "  sore  heels,"  and  for  a 
long  time  all  those  who  busied  themselves  with  the  question  of  vaccine 
confounded  "  sore  heels  "  with  a  number  of  different  diseases,  although 
as  early  as  1802  Loy  had  experimentally  proved  that  so-called  "  grease  " 
(in  reality  horse-pox)  was  transmissible  by  inoculation  to  the  cow,  in 
which  it  produced  cow-pox. 

Loy's  "grease"  and  Jenner's  "sore  heels"  only  represent  forms 
of  horse-pox,  but  for  more  than  fifty  years  the  origin  of  vaccine  was 
sought  in  grease,  lymphangitis,  and  other  diseases  which  attack  the 
extremities  of  horses'  limbs.  Petelard  (1845-1868)  rediscovered  and 
redescribed  horse-pox  and  proved  its  transmissibility  to  man;  Lafosse 
and  U.  Leblanc  discovered  it  in  an  epizooty  which  broke  out  at 
Rieumes ;  and  Bouley  in  1862  furnished  a  synthetical  description  of  it 
under  the  designation  of  horse-pox.  He  shows  that  horse-pox  is  always 
a  pustular  disease,  but  that  it  may  sometimes  appear  in  the  form  of 
a  discrete  eruption  around  the  lips  and  nostrils,  sometimes  of  an  erup- 
tion limited  to  the  pasterns  or  extremities  of  the  limbs  when  inoculation 
has  been  effected  in  this  region,  sometimes  of  lymphangitis,  and  some- 
times of  a  more  or  less  confluent  and  generalised  eruption. 

Symptoms.  The  disease  as  discovered  and  described  by  Jenner 
was  soon  rediscovered  and  redescribed  on  all  sides — by  Sacco  in  Italy, 
Hering  in  Germany,  etc. 

The  pustular  eruption  usually  appears  on  the  udder  in  the  case 
of  cows,  and  on  the  muzzle,  nose,  and  lips  in  that  of  calves.  In 
exceptional  cases  the  eruption  may  become  generalised. 

The  pustules  are  round  or  slightly  elliptical,  and  are  preceded  by 
the  appearance  of  red  congested  patches,  followed  by  infiltration  and 
thickening  of  the  skin. 

The  pustule  is  moderately  prominent,  and  after  some  days  there 
is  exudation  at  its  centre,  transforming  it  into  a  vesico-pustule.  The 
exuded  liquid  collects  under  the  thickened  layer  of  epidermis,  which 
it  raises,  and  on  examination  it  appears  as  a  white  or  transparent 
little  central  patch,  with  a  thin  grey  periphery  surrounded  by  a  reddish 
inflammatory  zone.  This  liquid  becomes  thicker  and  the  pustule  is 
flattened  at  its  centre,  then,  towards  the  eighth  or  ninth  day,  the 
pustule  is  ruptured,  owing  to  tearing  of  the  epidermic  patch.  The 
vaccine  thus  escapes. 

In  what  is  termed  spontaneous  vaccinia  the  udder  is  covered  with 
a  varying  number  of  pustules,  usually  in  different  stages  of  development. 
Some  are  very  small,  whilst  others  have  attained  the  size  of  sixpence 
and  are  already  in  course  of  cicatrisation. 


COW-POX — VACCINIA.  667 

When  cow-pox  is  accidental  or  the  result  of  inoculation,  the  eruption 
occurs  exactly  at  the  point  of  inoculation,  whether  the  latter  has  been 
through  an  abrasion,  a  puncture,  an  incision,  or  any  other  skin  injury, 
and  the  eruption  may  assume  the  most  varied  appearances,  according 
to  the  nature  of  the  primary  lesion,  although  the  mode  in  which  the 
pustules  themselves  form  never  varies.  Pustules  experimentally  pro- 
duced by  puncturing  the  parts  may  be  taken  as  a  type  of  inoculation. 
On  the  day  following  the  operation  nothing  abnormal  appears.  On 
the  third  day  there  is  a  slight  swelling  around  the  point  punctured, 
and  this  increases  until  the  fifth  day,  when  there  is  exudation,  which 
converts  the  primary  lesion  into  a  vesico-pustule.  On  the  sixth  day 
the  vesico-pustule  becomes  umbilicated  at  its  centre,  the  exudation  is 
abundant,  and  already  vaccine  might  be  collected. 

This  may  be  termed  the  period  of  crisis ;  the  appearances  are  most 
characteristic.  During  the  following  days  the  vesicle  is  ruptured ;  the 
discharge  continues  from  the  ninth  to  the  twelfth  day,  when  the  pustule 
diminishes  in  size  and  dries  up.  After  the  fifteenth  day  crusts  of  a 
brownish  colour  form ;  these  separate  between  the  twentieth  and 
twenty-fifth  days,  leaving  hard  whitish-looking  cicatrices,  which  per- 
manently remain. 

Moderate  itching  accompanies  the  development  of  the  eruption,  the 
principal  functions  are  not  disturbed,  and  fever  only  appears  in  the 
event  of  the  eruption  becoming  confluent  or  extending  over  a  large 
area.  When  the  eruption  is  generalised  the  pustules  or  vesico-pus- 
tules  are  found  mostly  in  the  region  of  the  elbow,  the  lower  border 
of  the  neck,  the  flank  and  the  inner  surface  of  the  limbs.  They 
present  exactly  the  same  appearance  as  the  pustules  on  the  surface 
of  the  udder,  but,  being  covered  with  hair,  are  less  open  to  inspection. 

In  certain  rare  cases  the  eruption  extends  to  the  perineum  and 
lips  of  the  vulva.  Signs  of  inflammation  then  develop  on  one  or  both 
sides,  the  tissues  display  oedematous  infiltration  and  disseminated  or 
confluent  pustules.  The  lymphatic  glands  and  vessels  in  the  neigh- 
bourhood of  the  pustules  are  always  swollen. 

Causation.  Cow-pox,  or  vaccinia,  is  a  virulent  disease  transmissible 
by  accidental  or  intentional  inoculation.  The  discharge  from  the  vesico- 
pustules  and  the  crusts  which  afterwards  cover  them  are  virulent, 
and  inoculation  can  be  performed  by  simply  scratching  the  skin.  A 
first  attack  confers  prolonged  and  sometimes  perfect  immunity,  the 
operation  being  successful  if  only  one  pustule  develops. 

The  disease  is  transmitted  to  healthy  animals  by  milkers,  by  calves 
in  sucking,  or  by  the  conveyance  in  whatsoever  form  of  virulent  material 
to  sores  or  cuts. 

The  nature  of  the  parasitic  or  microbic  agent  which  produces  the 


668  INFECTIOUS   DISEASES. 

disease  is  still  unknown.  Some  investigators  have  described  intra- 
cellular parasites,  others  extra-cellular  parasites,  others,  again,  blood 
parasites,  etc.,  but  the  exact  cause  has  always  eluded  research. 

It  is,  however,  known  that  filtration  of  vaccine,  pure  or  diluted, 
through  porcelain  removes  the  active  material,  which  remains  in  the 
residue  arrested  by  the  filter. 

Prolonged  exposure  to  a  temperature  above  104°  Fahr.  (40°  C.) 
greatly  diminishes  the  activity  of  the  vaccine.  Simple  desiccation  has 
no  action.  Warming  to  140°  Fahr.  (60°  C.)  for  fifteen  minutes  also 
destroys  its  action  completely. 

These  facts  explain  why  it  has  always  been  so  difficult  to  preserve 
and  cultivate  vaccine  in  tropical  regions. 

Mixed  with  equal  parts  of  neutral  glycerine,  the  virulent  material 
preserves  its  activity  unimpaired  for  from  six  to  eight  months. 

The  disease  develops  equally  in  man,  the  horse,  the  ox,  the  buffalo, 
the  goat,  and  the  camel.  Its  development  is  less  typical  in  the  pig, 
sheep,  dog,  and  rabbit.  Young  animals  are  best  adapted  for  its 
cultivation. 

The  blood  and  serum  of  animals  suffering  from  cow-pox  possess 
immunising  properties,  but  only  when  administered  in  very  large 
doses,    say   from    6    to   12    lbs.    of    blood,    or    ^    to    1    lb.    of    serum. 

The  curative  action  of  this  serum  against  small-pox  is  compara- 
tively trifling. 

The  diagnosis  of  cow-pox  is  not  very  difficult. 

At  first  the  disease  might  be  mistaken  for  false  cow-pox,  the  erup- 
tions of  foot-and-mouth  disease,  or  gangrenous  coryza. 

In  false  cow-pox,  the  nature  of  which  is  also  little  understood, 
although  it  is  known  to  be  contagious  and  is  regarded  by  some  as 
true  vaccinia,  the  pustules  are  smaller  and  thinner,  while  the  vesicle 
is  more  developed,  and  the  disease  runs  a  more  rapid  course. 

In  foot-and-mouth  disease  the  eruptions  are  of  the  nature  of 
vesicles  or  bullae,  not  pustules.  The  eruption  occurs  in  twenty-four 
hours  or  less,  and  can  only  be  mistaken  for  vaccinia  during  the 
period  of  desiccation  and  the  formation  of  crusts. 

Finally,  as  regards  gangrenous  coryza,  the  hardened  pustules  do 
not  produce  vesicles. 

The  prognosis  is  generally  favourable.  The  disease  runs  its  course 
within  relatively  fixed  periods,  according  to  the  development  of  the 
pustules,  and  recovery  occurs  without  complications. 

Treatment.  No  curative  treatment  can  be  laid  down,  the  develop- 
ment of  the  disease  being  perfectly  regular  and  tending  to  recovery. 
Simple  hygienic  precautions  and  cleanliness  are  sufficient  to  avoid 
complications  due  to  suppuration. 


COW-POX   AND    HUMAN    VARIOLA — PREPARATION    OF    VACCINE.        669 
COW-POX    AND    HUMAN    VARIOLA PREPARATION    OF    VACCINE. 

Time  and  experience  having  proved  that  inoculation  with  cow-pox 
or  vaccinia  protected  human  beings  against  small-pox,  the  question 
arose  as  to  the  connection  between  the  two  diseases,  whether  or  not 
they  were  identical  and  whether  vaccinia  in  the  bovine  animal  might 
not  merelj'-  represent  an  alternative  form  of  small-pox.  The  importance 
of  the  question  will  at  once  be  un"derstood  by  bearing  in  mind  the 
danger  to  which  human  beings  would  be  exposed  by  vaccination  with 
small-pox  virus  unmodified  by  passage  through  the  calf. 

Nevertheless,  at  the  present  time  the  opinion  of  the  early  writers 
appears  to  prevail,  and  the  theory  of  identity  is  accepted  by  the  great 
majority  of  scientific  men.  The  reason  why  experimenters  in  the 
second  group  came  to  believe  in  duality  is  that  the  method  of  inocula- 
tion chosen  (by  jDuncture)  was  not  entirely  reliable.  The  inoculations 
proved  too  slight,  and  it  is  only  after  inoculation  by  scarification  or 
incision  that  typical  eruj^tions  can  be  reproduced  in  series. 

Preparation  of  vaccine.  Whether  cow-pox  and  small-pox  are  or 
are  not  identical,  the  benefits  resulting  from  vaccination  are  none 
the  less  real,  and  it  is  to  be  hoped  that  vaccination  and  revaccina- 
tion  will  soon  be  made  obligatory  in  all  countries.  We  should  then  no 
longer  have  to  deplore  those  epidemics  of  small-pox  which  periodically 
cause  consternation  in  large  cities  and  colonies. 

The  preparation  of  vaccine  has  been  the  subject  of  such  minute 
care  in  every  country  that  neglect  of  vaccination  is  astonishing.  The 
material  is  obtained  from  calves  or  cows.  In  France  the  vaccine  is 
prepared  from  animals  of  five  to  eight  months  old,  free  from  disease. 
The  old  system  of  inoculation  by  puncture  has  been  completely 
abandoned,  the  yield  being  insufficient,  scarifications  or  incisions  being 
now  employed. 

The  animal  is  secured  or,  better  still,  laid  down  on  a  suitable  table, 
and  is  shaven  over  a  sufficient  surface.  The  inoculations  are  made  on 
the  sides  of  the  chest,  over  the  thorax  or  elsewhere,  but  preferably  over 
the  flank  and  thorax,  as  being  most  readily  accessible.  The  region  of 
operation  is  rendered  aseptic  as  far  as  possible,  and  scarified  in  lines 
about  1  to  2  inches  in  length,  the  lines  of  one  horizontal  row  alter- 
nating with  those  in  the  next.  It  is  imperative  that  the  slight  bleeding 
which  may  result  should  entirely  cease  before  inoculation  is  attempted. 

The  scratches  are  inoculated  with  the  purest  vaccine  obtainable, 
preferably  with  glycerinated  pulp  which  has  been  kept  for  six  weeks 
or  two  months.  From  the  third  day  the  lines  of  inoculation  become 
prominent,  and  an  indurated  longitudinal  swelling,  with  all  the  charac- 
teristics of  a  pustule,  soon  projects  above  the  neighbouring  portions 


670  INFECTIOUS    DISEASES. 

of  skin.  On  the  fifth  day  exudation  commences,  and  from  the  sixth  to 
the  seventh  day  a  large  quantity  of  vaccine  lymph  may  be  collected. 
The  line  of  inoculation  appears  slightly  umbilicated  and  surrounded 
by  a  greywish-white  zone  and  a  hard  peripheral  swelling. 

Vaccine  may  be  collected  from  the  fifth  day  in  summer  to  the 
eighth  day  in  winter. 

The  inoculated  area  having  been  cleansed  with  boiled  water  and 
carefully  dried,  the  little  crusts  ^vering  the  inoculation  wounds  are 
loosened  and  the  wounds  themselves  gently  scraped  with  a  special 
curette  of  small  size.     The  exuded  liquid  is  very  active. 

The  base  of  each  swelling  is  then  grasped  in  a  little  special  clamp, 
which  acts  like  a  pressure  forceps  and  causes  the  discharge  of  a  further 
large  quantity  of  active  vaccine  lymph.  All  the  material  thus  obtained 
is  mixed  ;  an  equal  quantity  of  neutral  glycerine  is  added,  the  whole 
is  finely  triturated,  passed  through  a  cloth,  and  stored  in  little  sterilised 
glass  tubes,  which  are  hermetically  sealed. 

The  vaccine  thus  prepared  retains  its  activity  for  from  five  to  eight 
months,  if  kept  from  the  action  of  heat  and  light.  Accidental  germs 
which  may  have  developed  in  the  wounds  and  thus  gained  entrance 
to  the  vaccine  gradually  lose  their  activity.  After  from  forty  to  sixty 
days  the  vaccine  may  be  regarded  as  absolutely  pure  and  incapable 
of  producing  accidental  suppuration,  as  sometimes  occurs  when  fresh 
vaccine  is  employed. 

The  old  electuaries,  dried  vaccines,  vaccine  pastes,  etc.,  have  been 
almost  entirely  given  up,  the  above  method  always  yielding  a  pure 
and  active  vaccine.  Vaccination  with  calf  lymph  should  always  be 
preferred  to  vaccination  from  arm  to  arm,  in  view  of  possible  trans- 
mission of  grave  disease,  such  as  syphihs.. 

TETANUS. 

Tetanus  is  a  disease  characterised  by  tonic  contraction  of  the 
muscles  of  one  or  more  limbs  or  of  all  the  muscles  of  the  body. 

Causation.  It  is  due  to  the  growth  of  Nicolaier's  bacillus  in  some 
part  of  the  body  (in  accidental  wounds,  in  the  uterine  cavity  after 
parturition,  etc.),  and  the  contraction  of  muscles  is  due  to  toxins 
(elaborated  by  the  microbe),  which  have  a  selective  affinity  for  the 
nervous  centres. 

These  toxins,  secreted  by  bacilli  localised  in  wounds,  are  absorbed 
and  carried  away  by  the  lymphatic  and  vascular  channels  and  dis- 
tributed throughout  the  body.  They  seem  chiefly  to  affect  the  cells  of 
the  central  nervous  system.  Infection  is  due  to  microbes  capable  of 
living  as  saprophytes  outside  the  animal  body. 


TETANUS.  671 

Nicolaier's  bacillus  assumes  the  form  of  a  straight  rod,  one  end  of 
which  is  swollen  by  the  presence  of  a  spore.  It  is  anerobic,  grows  in 
a  number  of  different  media,  most  rapidly  at  a  temperature  of  100"  to 
102°  Fahr.  (38°  to  39°  C),  and  stains  well  by  Gram's  method. 

Though  quite  common  in  the  horse,  tetanus  is  rare  in  other 
domestic  animals. 

In  the  ox  it  may  result  either  from  mechanical  injuries,  suppu- 
rating sores,  or  surgical  operations.  In  the  cow,  goat,  and  sheep  it 
sometimes  assumes  the  form  of  a  true  enzooty  after  parturition  if  the 
byres,  etc.,  are  not  disinfected.  In  male  animals  it  principally  follows 
castration  by  one  of  the  cutting  methods,  and  in  lambs  is  seen  after 
amputation  of  the  tail.  A  large  number  of  animals  belonging  to  one 
flock  may  be  affected,  and  Moussu  has  known  two-thirds  of  a  given 
number  of  castrated  lambs  to  die  of  tetanus. 

Despite  the  sensitiveness  of  domesticated  animals  to  tetanic  infec- 
tion they  may  all  be  protected,  either  by  injections  of  cultures,  or  by 
gradually  increasing  injections  of  specific  toxin.  The  latter,  however, 
are  more  efficacious  when  modified  by  the  addition  of  terchloride  of 
iodine  or  of  iodine  water.  The  blood  of  immunised  subjects  rapidly 
acquires  antitoxic  powers,  which  may  be  greatly  increased  for  the  pur- 
pose of  obtaining  anti-tetanic  serum. 

The  symptoms  of  tetanus  are  the  same  in  all  species. 

In  the  first  stage  the  animal  appears  stiff,  walks  in  a  jerky  way 
and  holds  the  head  high,  with  the  ears  pricked.  The  eyes  are 
slightly  withdrawn  into  the  orbits,  and  the  animal  shows  marked 
general  excitability. 

In  the  second  stage  there  are  muscular  contractions,  together  with 
trismus,  stiffness  of  the  neck,  limbs  and  vertebral  column,  spasm  of 
the  spinal  muscles  and  muscles  of  the  limbs  (tonic  contraction),  and 
the  animal  has  a  peculiar,  staring  look. 

In  the  third  stage  mastication  becomes  difficult  or  impossible, 
respiration  is  impeded,  and  the  animal  suffers  from  spontaneous 
attacks  of  muscular  contraction  or  from  attacks  due  to  external 
stimulation  (noises,  sudden  movements,  changes  from  darkness  to 
light,  etc.). 

In  the  fourth  stage  the  animal  is. liable  to  fall,  asphyxia  threatens, 
and  death  occurs  from  respiratory  syncope. 

Recovery  is  quite  exceptional  in  the  sheep,  goat,  and  ox;  death 
usually  occurs  between  the  second  and  sixth  days. 

Diagnosis.  Tetanus  being  less  common  in  the  ox,  sheep,  and  goat 
than  in  the  horse,  the  diagnosis  is  not  so  easy  in  these  animals,  but 
as  it  develops  under  different  conditions,  and  as  it  usually  attacks 
several   animals    in   one    byre   or   fold,   the    diagnosis    is   rarely   very 


672  INFECTIOUS   DISEASES. 

difficult.  At  the  worst  some  hesitation  may  he  felt  at  first,  the 
condition  heing  mistaken  for  disease  of  the  hrain. 

The  prognosis  is  extremel.y  grave. 

The  treatment  is,  ahove  all,  of  a  preventive  nature,  investigation 
having  proved  that  injections  of  anti-tetanic  serum,  ])efore  the  first 
appearance  of  tetanus,  are  invariably  effectual. 

If,  therefore,  one  case  of  tetanus  appears  in  a  byre  at  calving  time 
or  in  a  flock  at  the  season  when  the  lambs  are  castrated,  no  hesitation 
should  be  felt  in  preventively  inoculating  all  the  castrated  animals  and 
the  cows  which  have  calved.  The  quantities  required  are,  for  a  cow 
10  ce.  (about  3  fluid  drachms)  and  for  a  sheep  5  cc.  of  anti-tetanic 
serum. 

This  treatment,  however,  should  be  supplemented  by  general 
hygienic  precautions  and  internal  treatment,  such  as  irrigation  and 
disinfection  of  the  parts  affected. 

Curative  treatment  has  little  chance  of  success.  Experiments  have 
also  proved  that  when  the  first  symptoms  of  tetanus  appear,  anti-tetanic 
serum  is  powerless  to  prevent  the  development  of  the  disease.  Never- 
theless, as  its  gravity  is  in  direct  ratio  to  the  quantity  of  toxin  absorbed, 
and  as  the  degree  of  this  absorption  depends  on  the  length  of  time  that 
the  place  remains  infected,  the  first  thing  to  be  done  is  to  disinfect 
and,  in  certain  cases,  curette  the  wounds  which  are  believed  to  be  the 
source  of  mischief.  Although  antiseptics  have  little  action  on  Nico- 
laier's  bacillus,  they  may  be  used.  Solutions  of  iodine  appear  most 
active,  both  as  regards  ordinary  wounds  and  infection  of  the  uterus. 

General  tonics,  diuretics,  and  lukewarm  gruels  can  be  given.  Un- 
fortunately the  patients  are  often  unable  to  swallow  them.  In  such 
cases  both  liquids  and  medicines  may  be  directly  introduced  into  the 
rumen  by  puncturing  the  parts  with  a  trocar  and  canula,  the  latter 
being  left  in  position. 

Intravenous  injections  of  large  quantities  of  normal  salt  solution 
are  also  of  considerable  value,  4  to  6  quarts  per  day  for  an  ox 
and  20  to  40  fluid  ounces  per  day  for  a  sheep. 

ACTINOMYCOSIS. 

Actinomycosis  is  a  disease  produced  by  a  fungus  belonging  to  the 
group  of  oomycetes  {Actinomyces  hovis)  which  develops  in  the  depths 
of  living  tissues  in  man  and  the  ox,  producing  grave  and  sometimes 
incurable  lesions,  most  commonly  in  and  about  the  jaws. 

Actinomycosis  is  very  common  in  America,  and  is  also  met  with 
in  all  parts  of  Europe. 

Symptoms.     The  disease  assumes  many  dilierent  clinical  forms,  but 


ACTINOMYCOSIS    OF    THE    MAXILLA. 


673 


it   more   frequently  attacks  some  parts  of  the  body  than  others,  and 
by  far  the  greater  number  of  cases  occur  in  the  ox. 


ACTINOMYCOSIS    OF    THE    MAXILLA. 

Actinomycosis  of  the  maxilla  attacks  young  animals,  and  its  usual 
seat  is  in  the  molar  region,  although  occasionally  it  affects  the  incisors. 

The  earliest  symptoms  consist  in  swelling  of  the  bone,  which  may 
be  overlooked  if  within  the  mouth,  but  the  outline  of  the  jaw  soon 
becomes  deformed,  generally  in  the  middle  region  of  the  row  of  molars. 
Somewhat  tender  and  firm  to  the  touch  at  first,  the  tumour  gradually 
increases  in  size,  invades  the 
deeper  regions  of  the  skin, 
and  displays  fluctuation  at 
one  or  two  points,  followed 
by  abscess  formation.  The 
pus  discharged  may  be  white, 
creamy,  and  inofl^ensive,  but 
the  cavity  of  the  abscess 
shows  no  tendency  to  cica- 
trise, and  the  opening  through 
which  the  pus  has  escaped  is 
transformed  into  a  fistula. 
From  this  moment  the  pus  dis- 
charge is  of  a  greyish,  sanious 
nature,  and  contains  a  greater 

or  less  number  of  little  yellowish  grains.  It  soon  acquires  an  offen- 
sive odour,  and  the  fistulous  opening  is  surrounded  by  exuberant  granu- 
lations, forming  a  fungoid  mass. 

The  neighbouring  tissues  become  hardened  and  lose  their  sensitive- 
ness, the  jaw  becomes  completely  deformed,  and  a  condition  is  set  up 
which  the  old  writers  considered  as  true  cancer  of  the  jaw  or  maxillary 
osteosarcoma  (Fig.  268). 

A  probe  passed  into  the  fistula  penetrates  deeply,  usually  into  the 
thickness  of  the  jaw  itself,  and  however  carefully  manipulated  injures 
the  diseased  tissues  and  causes  free  bleeding. 

If  neglected,  these  lesions  become  steadily  worse,  mastication  is  more 
difficult,  being  possible  only  on  the  healthy  side,  and  the  animals  lose 
condition  and  eventually  die  of  exhaustion.  The  external  lesion,  repre- 
sented by  the  fungoid  mass,  increases  in  size,  assumes  a  blackish  colour, 
and  discharges  an  offensive  liquid.  Portions  of  it  undergo  mortifica- 
tion and  give  oft'  a  characteristic  and  extremely  foetid  odour.  The 
molars  become  loose  and  in   some  cases  fall  out,  but  development  is 

B.C.  X  X 


Fig.  268. — Actinoinj'cosis  of  the  jaw. 


674 


INFEC'JIOUS    DISEASES. 


usuall}^  slow,  and  some  weeks  or  months  elapse  before  this  stage  is 
reached. 

When  the  disease  attacks  the  region  of  the  incisors  the  symptoms 
are  much  sooner  apparent,  and  treatment  is  much  easier.  The  parasitic 
invasion  results  from  an  injury  to  the  jaw  caused  by  shedding  of  the 
milk  teeth.  Swelling  of  the  body  of  the  jaw  thrusts  the  lower  lip 
downwards,  interferes  with  the  prehension  of  food,  and  calls  for 
prompt  treatment.  The  disease  is  rarely  allowed  to  attain  the  degi-ee 
of  development  shown  in  Figs.  269  and  270. 

As  in  the  preceding  instance,  the  animals  die  of  exhaustion  unless 
relieved. 

For  reasons  difficult  to  explain,   but  probably  because   inoculation 


Fig.  269. — Actinomycosis  in  the  region 
of  the  incisors. 


1         # 


Fig  270  — A(  tmonncoM^  in  the 
legion  of  tlie  iiici^-oi^. 


is  less  easy,  actinomycosis  is  much  i-arer  in  the  upper  than  in  the 
lower  jaw.  The  disease  develops  exactly  as  above  described,  but 
shows  much  less  tendency  to  external  ulceration.  It  invades  the 
maxillary  sinus  and  the  region  of  the  palate,  and  fistulae  are  found 
opening  into  the  buccal  cavity,  while  at  the  same  time  the  region  of 
the  forehead  is  often  deformed. 


ACTINOMYCOSIS     OF     THE     TONGUE. 


Actinomycosis  attacks  the  tongue  apart  from  any  lesion  of  the 
jaws,  and  produces  what  is  commonly  called   "wooden  tongue." 

The  disease  develops  in  the  tongue  itself,  generally  in  the  sub- 
mucous zone,  and  causes  chronic  interstitial  inflammation,  infiltration 


ACTINOMYCOSIS. 


G75 


of  the  connective  tissue,  and,  in  time,  changes  in  the  muscular  struc- 
tures themselves. 

The  tongue  shows  progressive  hypertrophy,  and  becomes  hard,  sensi- 
tive, rigid,  and  incapable  of  free  movement.  As  a  result  the  patients 
first  have  difficulty  in  grasping  food,  then  in  swallowing  their  saliva, 
which  dribbles  from  the  mouth,  and  finally  are  quite  unable  to  feed 
themselves. 

The  tongue  is  enlarged  and  indurated,  and  fills  the  entire  cavity 
of  the  mouth.  Sometimes  it  projects  beyond  the  incisors,  excoriated 
and  bleeding.  On  passing 
the  hand  into  the  mouth  it 
is  found  that  the  surface  is 
covered  with  little  yellowish 
or  red  ulcerated  nodules, 
varying  in  size  from  that  of 
a  large  pin's  head  to  that  of 
a  lentil. 

In  eating,  the  animals 
seize  food  between  the  lips 
and  lift  the  head  high,  so 
as  to  allow  the  food  to  fall 
between  the  rows  of  molars. 
The  motion  is  very  similar 
to  that  of  a  fowl  drinking, 

ACTINOMYCOSIS  OF  THE  PHARYNX, 
PAROTID    GLANDS    AND    NECK. 

Actinomycosis  may  some- 
times leave  the  mouth  and 
tongue  unaftected  and  attack 
the  pharjaix,  from  which  it 
extends    in    the    direction    of 

the  parotid  glands  and  external  surface  of  the  neck.  In  these  cases, 
however,  the  inoculations  are  more  localised  than  when  the  surface 
of  the  tongue  is  attacked,  and  the  lesions  consist  of  vegetations,  polypi, 
or  actinomycomata. 

The  growths  develop  on  the  posterior  pillars  of  the  fauces,  on  the 
sides  of  the  pharynx,  or  near  the  entrance  to  the  oesophagus.  They 
interfere  with  swallowing,  and  produce  symptoms  which  are  easy  to 
detect  and  interpret. 

The  lesions  may  also  afi'ect  deeper-seated  tissues  and  produce 
growths  in  the  parotid  or  subparotid  region,  or  lead  to  the  develop- 
ment of  fistulas  in  the  region  of  the  neck.     Most  fistulae,  however,  in 

X  X  2 


Fig.  271  — Actinomycosis  of  the  tongue. 


676 


INFKCTIOUS    DISEASES. 


this  region  are  due  to  specific  inoculation  of  external  injuries.  Fistulse 
originating  in  tlie  parotid  region  and  in  the  upper  part  of  the  neck 
usually  resemble  in  appearance  the  maxillary  fistulae.  The  external 
fungoid  growth,  however,  is  less  exuberant,  suppuration  is  less  abun- 
dant, and  the  surrounding  induration  less  extensive. 

Various  localisations.     Although  the  disease  generally  attacks  the 
mouth,    tongue    or   pharynx,    it   may    invade    the   oesophagus,    rumen. 


Fict.  272. — Actinomycosis  of  niaiumary  gland  (cow). 


reticulum,  liver  and  intestine,  larynx,  trachea,  lung,  peritoneum, 
epiploon,   and   even  the  udder. 

Localisations  in  the  udder  and  peritoneum  are  commonest  in  pigs, 
and  it  is  believed  that  inoculation  occurs  either  through  the  galacto- 
phorous  sinuses  or  through  the  abdominal  wounds  made  for  purposes 
of  castration. 

Causation.  The  cause  of  actinomycosis  is  to  be  sought  in  the 
development  of  Actiuoiiii/crs  horis  within  living  tissues.  It  seems  pro- 
blematical whether  the  germs  to  be  found  in  the  pus  or  saliva  of 
affected  animals  ever  directly  infect  new  hosts,  and  it  is  difficult  to 
carry  out  infection  in  this  manner  even  in  very  sensitive  experimental 


ACTINOMYCOSIS.  6^7 

animals.  Nevertheless,  the  persistence  of  the  disease  in  certain  byres 
would  seem  to  support  the  view  of  direct  infection. 

On  the  other  hand,  it  is  proved  that  the  actinomyces  is  a  parasite 
affecting  vegetables,  principally  the  graminaceae,  and  that  domestic 
animals  are  most  commonly  infected  through  injuries  caused  by  vege- 
table substances.  This  is  suggested  by  the  discovery  of  the  debris 
of  grain  at  the  point  where  the  lesions  have  originated. 

Inoculation  is  commonest  in  the  mouth  and  on  the  surface  of  the 


'^. 


Fig.  273. — Actinomycosis  of  uiaunuaiy  gland  (cow),  showing  growth 
invading  lobules.     (Figs.  272  and  273  are  from  blocks  kindly 
supplied  by  Mr   Gilruth,  F.E.C.V.S.). 

tongue,  parts  which  are,  so  to  speak,  permanently  excoriated.  The 
shedding  of  the  temporary  molars  favours  such  accidents,  and  this  is 
why  actinomycosis  of  the  jaw  is,  relatively,  so  common.  The  incisor 
region  may  also  be  inoculated  during  the  shedding  of  the  milk  teeth, 
but  as  the  infected  food  comes  more  closely  and  for  much  longer 
periods  in  contact  with  the  molars,  it  is  easy  to  understand  why 
actinomycosis  is  rarer  in  the  incisor  region. 

The  conditions  are  less  favourable  for  inoculation  of  the  pharynx, 
because     food    does    not    remain   in    position    there    for    more    than    a 


mFECTlOlTS   DISEASES. 


second  or  two,   but  when   the  epithelium  has  been  shed   as  a  conse- 
quence of  laryngitis  or  pharyngitis,  infection  may  occur. 

As  regards  cutaneous  inoculation,  the  parasite  only  seems  dan- 
gerous when  the  skin  is  excoriated  or  injured  either  accidentally  or 
as  the  result  of  surgical  interference. 

Actinomycosis  of  the  lung  is  probal)ly  caused  by  the  germs  being 

inhaled    along  with 
the  inspired  air. 

Lesions.  The 
lesions  are  very  pe- 
culiar in  character, 
and  end  in  com- 
pletely destroying 
the  tissues  invaded. 
Once  lodged 
within  an  organ, 
the  disease  shows 
a  tendency  to  ex- 
tend in  all  direc- 
tions, and,  despite 
the  defensive  reac- 
tion of  the  tissues, 
it  soon  forms 
numerous  parasitic 
centres. 

In    bones,  for 
example,  actinomy- 
cosis    invades    the 
spongy   tissue   with 
the    greatest    ease. 
It   causes    subacute 
ostitis,  which   leads 
to   diffuse  suppura- 
tion    and     local 
hypertrophy  of   the  bone,  destruction   of  the  compact  layers,  and  the 
development  of  an  abscess  with  fungoid,  exuberant,  granulating  walls 
which  show  no  reparative  tendency  whatever. 

The  pus  of  the  abscess  and  the  liquid  from  the  fistula  contain 
varying  quantities  of  yellowish  grains,  representing  clusters  of  actino- 
myces.  The  surrounding  tissues,  muscles,  tendons,  skin,  etc.,  are  all 
involved  before  long  in  the  inflammatory  process,  and  the  granulating 
masses  themselves  are  invaded  by  the  yellowish  parasitic  tufts.  All 
the  fistulse  are  surrounded  by  enormous  zones  of  iniiltration,  which  on 


274. — Old-standing  bone  lesions  in  a  case  of 
actinomycosis  of  the  jaw. 


ACTINOMYCOSIS. 


679 


incision  exhibit  a  lardaceous  appearance.  On  section  it  may  appear 
that  the  lesion  is  confined  entirely  to  the  bone,  though  this  is  excep- 
tional (Fig.  274).  Ordinarily  the  neighbouring  tissues  are  also  de- 
stroyed, and  not  infrequently  there  is  communication  with  the  ex- 
ternal air.  Sections  then  display  a  fungoid  tissue,  interspersed  with 
perforated  lamella  of  bone  and  lardaceous  tissue  containing  cavities 
crammed  with  actinomyces. 

The  lesions  in  the  parotid  regions,  the  neck  or  other  parts  attacked 
always  present  the  same  appearance,  viz.,  wide,  tortuous,  bifurcated 
fistula;,  with  exuberant  granulations  both  in  the  direction  of  the  cavi- 
ties and  of  the  exterior,  together  with  lardaceous  induration  of  the 
tissues  and  abundant  foetid  liquid 
pus. 

When  it  affects  the  tongue  the 
parasite  is  to  be  found  in  the  sub- 
mucous region,  where  it  causes 
little  swellings,  which,  when  super- 
ficial, rapidl}^  undergo  ulceration. 
The  subjacent  regions,  the  inter- 
stitial connective  tissue,  and  the 
muscular  tissue  become  infiltrated, 
hardened  and  progressively  scle- 
rosed. The  tongue  is  gradually 
hypertrophied,  and  soon  it  becomes 
as  hard  as  wood,  whence  the  term 
"  wooden  tongue." 

Actinomycosis  of  the  lung 
may  easily  be  mistaken  for  tuber- 
culosis, for  the  centres,  although 

usually  confined  to  one  lobe,  may  also  be  disseminated.  The  lesions, 
however,  are  surrounded  by  an  abundant  fibro-sclerous  inflammatory 
tissue. 

In  the  abdominal  cavity,  particularly  in  sows,  actinomycotic  lesions 
occur  as  little  masses  varying  in  size  between  that  of  a  pea  and  that 
of  a  haricot  bean,  attached  to  the  epiploon  and  peritoneum  and  filled 
with  pus  containing  mycosic  grains. 

Diagnosis.  Actinomycosis  is  usually  easy  to  recognise,  both  on 
account  of  the  special  character  of  the  lesions  and  the  presence  of 
the  little  grains  formed  by  the  parasite.  The  practitioner  will  rarely 
fail  to  recognise  at  once  the  signs  of  actinomycosis  of  the  jaw,  but 
actinomycosis  of  the  tongue  is  more  apt  to  be  mistaken  for  deep-seated 
sclerosing  glossitis,  although  a  careful  examination  will  always  enable 
the  different  symptoms  to  be  distinguished. 


Fig.  275. — Highly-magnified  clump 
of  actinomyces. 


G8()  INFECTIOUS   DISEASES. 

It  is  otherwise  with  regard  to  growths  in  the  pharj^ix  and  oesophagus, 
for,  until  after  removal,  simple  polypi  cannot  be  distinguished  from 
actinomj'cotic  growths.  In  such  cases  the  administration  of  iodide  of 
potassium  affords  valuable  indications. 

The  prognosis  is  grave,  whatever  the  clinical  form  of  the  disease. 
Important  advances,  it  is  true,  have  lately  been  made,  and  the  iodide 
of  potassium  treatment  is  of  great  value,  but  too  much  must  not  be 
expected  of  it,  and  its  benefits  have  certainly  been  exaggerated.  Clinical 
experience  suffices  to  prove  that  only  actinomycosis  of  soft  tissues  can 
be  cured  by  drugs,  bony  lesions  being  amenable  only  to  medical  and 
surgical  treatment  combined.  Even  combined  treatment  is  often  un- 
successful. 

Treatment.  Thomassen  in  1885  first  explained  the  favourable  action 
of  iodide  of  potassium  on  actinomycotic  growths,  and  Nocard  in  1892 
again  directed  public  attention  to  the  advantages  attending  the  use 
of  this  drug  both  in  man  and  the  lower  animals.  As  too  frequently 
happens,  however,  the  benefits  of  this  treatment  have  been  exagge- 
rated, and  iodide  of  potassium  has  been  held  out  as  a  specific  even 
against  lesions  in  bone.  With  very  few  exceptions  this  is  incorrect,  and, 
as  Moussu  has  shown,  when  the  disease  affects  bone  tissue  it  only 
yields  to  mixed  treatment. 

The  treatment  of  actinomycosis  may  therefore  be  considered  under 
two  heads. 

Firstly,  the  treatment  of  actinomycosis  of  soft  tissues ;  and,  secondly, 
that  of  bone. 

Actinomycosis  of  soft  tissues,  muscle,  sldn,  lymphatics,  serous  mem- 
branes, etc.,  comprises  the  most  common  forms  of  actinom3^cosis,  viz., 
those  of  the  tongue,  pharynx,  parotid  glands,  neck,  etc. 

The  second  form  comprises  actinomycosis  of  the  lower  jaw  (molar 
region),  the  upper  jaw,  region  of  the  incisors,  etc. 

Iodide  of  potassium  in  daily  doses  of  from  2  to  3  drachms  is  almost 
a  specific  in  dealing  with  the  first  form  of  disease. 

In  lingual  actinomycosis,  for  example,  the  effects  may  be  seen  a 
few  days  after  treatment  is  begun.  The  tongue  becomes  softer  and 
more  mobile,  can  be  protruded  beyond  the  mouth  and  retracted  into  it, 
and  day  by  day  tends  progressively  to  resume  its  normal  appearance. 

The  patients,  which  were  previously  slowly  dying  of  inanition  be- 
cause they  were  unable  to  feed  themselves,  again  take  to  their  food 
and  begin  to  put  on  flesh.  To  ensure  the  treatment  being  efficacious 
it  should,  as  a  rule,  be  continued  for  three  or  four  weeks. 

During  the  coarse  of  this  treatment  the  system  becomes  saturated 
with  the  drug,  but  no  bad  effects  follow.  The  patients  suffer  from 
lachrymation,  coryza,  bronchorrhsea,  and  especially  iodic  eczema,  but 


Actinomycosis  of  bone.  081 

all   these   symptoms  diminish   and  disappear  soon  after  the  adminis- 
tration of  the  drug  is  discontinued. 

Recovery,  however,  is  not  always  permanent,  and  even  when  the 
tongue  has  resumed  its  normal  appearance  a  relapse  may  occur.  We 
have  seen  several  such  cases  after  treatment  extending  over  more  than 
six  weeks,  and  it  is  therefore  often  advisable  to  fatten  the  animals  as 
rapidly  as  possible  and  prepare  them  for  slaughter. 

If  no  relapse  occurs,  and  recovery  is  regarded  as  permanent, 
another  complication  may  make  its  appearance,  viz.,  sclerous  atrophy 
of  the  tongue.  This  is  almost  as  dangerous  as  the  primary  lesion, 
because  it  prevents  the  animals  from  feeding,  and  constitutes  an  addi- 
tional reason  for  following  the  course  above  suggested. 

Other  lesions  of  soft  tissues,  such  as  disease  of  the  parotid  or  cer- 
vical glands,  etc.,  yield  to  the  same  treatment,  but  it  is  advisable  first 
of  all  to  clean  out  the  fistulfe,  scrape  off  exuberant  granulations,  cleanse 
the  irregular  culs-de-sac,  and  thoroughly  curette  all  accessible  parts. 

Treatment  is  much  longer  than  in  the  case  of  actinomycosis  of 
the  tongue,  but  it  is  not  always  necessary  to  push  the  remedy  to 
extreme  limits.  As  soon  as  symptoms  of  iodism  appear  only  a  drachm 
or  two  of  the  drug  need  be  given  daily. 

Actinomycosis  of  Bone. — As  a  general  rule,  actinomycosis  of  bone 
resists  the  administration  of  iodide  of  potassium,  a  fact  probabl}^  ex- 
plained by  the  much  less  abundant  blood  supply  in  bone  as  com- 
pared with  very  vascular  tissues,  such  as  the  tongue. 

To  have  any  chance  of  success  the  iodide  treatment  must  be  sup- 
plemented by  surgical  interference.  As  regards  the  surgical  aspect 
of  the  case,  the  affected  bone  should  be  removed  as  far  as  possible, 
together  with  all  broken-down  tissue.  Should  this  be  neglected,  the 
disease  returns  in  a  little  while. 

In  actinomycosis  of  the  region  of  the  incisors  the  method  is  radical 
when  adopted  in  time.  The  bod}^  of  the  maxilla  can  be  partiall}^ 
removed  with  a  fine  saw,  two  cuts  being  made  disposed  thus  :  <  (the 
letter  V  sideways).  The  upper  and  lower  layers  of  compact  tissue 
should  be  spared  as  much  as  possible,  so  that  the  body  of  the  bone 
may  not  afterwards  break.     Recovery  is  only  a  matter  of  time. 

A  very  small  local  iodoform  dressing  is  applied,  and,  when  healthy 
granulations  appear,  cicatrisation  can  be  left  to  natural  means. 

Cases  of  actinomycosis  of  the  jaw  are  much  more  troublesome.  If, 
as  usually  happens,  the  lesion  is  ulcerated  before  the  practitioner  is 
called  in,  the  external  fungoid  growth  should  be  removed  by  means 
of  an  elliptical  incision  through  the  skin,  the  axis  of  the  ellipse  being 
parallel  with  the  branch  of  the  maxilla.  The  bony  fistula  is  then 
exposed. 


682  INFECTI01T«    DISEASES. 

In  following  up  this  fistula  care  must  be  taken  not  to  injure  the 
facial  artery,  the  facial  vein,  or  Stenon's  duct.  Once  the  bone  is 
exposed  the  disease  can  be  attacked  in  the  depths.  The  diseased 
interior  is  cut  away  by  means  of  a  special  curette,  all  affected  por- 
tions being  removed,  and  an  iodine  or  iodoform  dressing  is  then 
applied. 

The  operation  is  extremely  troublesome,  owing  to  the  enormous 
bleeding,  and  sometimes  it  is  impossible  to  carry  out  successfully, 
as  in  the  case  of  old-standing  and  extensive  lesions.  To  ensure 
recovery  under  such  circumstances,  it  is  necessary  to  remove  a  por- 
tion of  the  branch  of  the  jaw,  and  this,  though  quite  possible  from 
the  scientific  standpoint,  would  not  be  worth  while  in  an  animal,  the 
value  of  which  is  usually  small. 

Curettage  of  the  bone  is  only  of  value  in  dealing  with  recent 
lesions,  and  even  then  should  not  be  practised  except  in  tlie  case  of 
animals  which  the  owners  particularly  desire  to  keep. 

In  cases  of  actinomycosis  of  the  upper  jaw  surgical  treatment  is 
just  as  difficult  as  in  the  lower  jaw,  and  calls  for  similar  precautions. 

The  diseased  portions  of  bone  having  been  removed,  the  cavity  is 
plugged  with  iodoform  or  cotton-wool,  or  a  dressing  saturated  with 
boric  acid  and  iodoform. 

In  all  surgical  operations  it  is  important  not  to  injure  the  dental 
arteries  or  nerves,  or  the  alveolo-dental  periosteum. 

TUBERCULOSIS. 

Tuberculosis  is  a  contagious  disease  produced  by  the  action  of 
Koch's  bacillus.  It  is  common  to  man  and  all  domesticated  animals, 
but  it  specially  affects  animals  of  the  bovine  species.  Its  existence 
has  long  been  recognised,  although  in  oxen  it  was  formerly  con- 
founded with  the  lesions  of  peri-pneumonia  and  echinococcosis. 

It  was  not  until  the  beginning  of  the  nineteenth  century  that 
Laennec  (1811)  described  the  tuberculous  lesion  from  the  anato- 
mical and  pathological  standpoint.  Giirlt  pointed  out  for  the  first 
time  in  1881  the  similarity,  the  identity  in  fact,  of  tuberculous  lesions 
in  man  and  the  ox. 

In  1865  Villemin  showed  that  tuberculosis  could  be  conveyed 
from  animal  to  animal,  always  producing  similar  lesions,  and  in 
1868  Chauveau  proved  that,  in  the  calf,  infection  might  arise  simply 
from  the  eating  of  tuberculous  material. 

At  a  somewhat  later  date  doubts  were  entertained  regarding  the 
identity  of  human  and  bovine  tuberculosis.  Virchow  denied  the 
identity  of  the  two  diseases  on  the  basis  of  a  comparative  study  of 
the  lesions.     His  opinion,  however,  has  not  prevailed,  and  the  doctrine 


TUfiERCULOSTM.  68f} 

of  the  identity  of  tuberculosis  in  mammals  still  appears  probable,  in 
spite  of  the  recent  declarations  of  Koch  (1901). 

Causation.  Tuberculosis  is  due  solely  to  the  activity  of  the 
tubercle  bacillus.  In  1884  Koch  isolated  and  cultivated  this  bacillus 
in  living  animals,  and  always  reproduced  typical  tuberculous  lesions 
by  injecting  cultures.  In  1887  Nocard  and  Eoux  described  a  rapid 
method  of  .cultivating  the  bacillus,  and  in  1890  Koch  announced  the 
discovery  of  tuberculin. 

The  tubercle  bacillus  assumes  the  form  of  a  little  rod,  five  or  six 
micro-millimetres  in  length,  and  '03  to  "Oo^  in  thickness.  It  has  a 
special  staining  reaction  when  treated  with  Ehrlich's  or  Ziehl's 
solution.  It  grows  between  98°  and  104°  Fahr.  (37°  and  40°  C.)  in 
various  artificial  media  containing  glycerine. 

Healthy  subjects  become  infected  by  the  accidental  entrance  of 
germs  into  their  bodies,  either  by  the  respiratory  and  digestive  tracts, 
or  through  solutions  of  continuity  in  the  skin. 

The  material  from  tuberculous  centres  is  virulent,  whether  con- 
sisting of  sputum  or  discharge,  saliva,  faeces,  urine,  milk,  etc.,  or 
tuberculous  tissues  derived  from  the  different  viscera. 

The  blood  and  muscular  tissues  are  not  always  virulent,  even  in 
cases  of  generalised  tuberculosis. 

The  virulent  organisms  usually  enter  the  body  through  the  lym- 
phatic system;  invasion  proceeds  from  the  point  inoculated  towards  the 
nearest  lymphatic  glands  and  thence  along  the  chain  of  lymphatic 
vessels,  and  the  lesions  extend,  attacking  the  internal  organs  more 
or  less  rapidly.  The  body  does  not  necessarily  become  fatally  in- 
fected as  a  consequence  of  accidental  or  even  experimental  infection, 
for  the  bacillus  may  itself  be  destroyed  by  the  phagocytes,  or  the 
lesion  may  remain  purely  local. 

Although  tuberculosis  is  the  gravest  and  most  widespread  disease 
on  the  surface  of  the  globe,  its  contagious  character  is  relatively  little 
marked,  a  fact  which  has  unfortunately  led  to  its  receiving  little 
attention  in  ordinary  life. 

Contagion  is  usually  the  result  of  cohabitation,  although  contact 
between  diseased  and  healthy  subjects  for  a  period  of  some  days  or 
even  weeks  does  not  seem  sufficient  to  produce  the  disease.  Nocard 
has  fixed  a  mean  period  of  five  to  six  months  as  necessary  for  the 
contraction  of  the  disease  by  bovine  animals,  and  Moussu  has  arrived 
at  almost  identical  results  by  placing  tuberculous  and  healthy  cows 
together  in  a  byre  reserved  for  such  researches.  In  this  connection, 
however,  very  great  differences  of  individual  susceptibility  exist,  and 
these  are  difficult  to  appreciate  in  the  present  state  of  our  knowledge. 
It  thus  happens  that  an  animal  of  vigorous  appearance  and  in  good 


684  iNFECTiOUS   blSEASES. 

condition    may  easily  coiitract   tuberculosis,  whilst  a  tbiniier  and  less 
vigorous  one  will  resist  it  for  a  comparatively  long  time. 

Speaking  generally,  it  may  be  said  that  young  animals  contract 
tuberculosis  by  cohabitation  in  infected  places  more  easily  than  adult 
or  aged  ones,  and  the  fact  that  old  animals  oontril)ute  the  larger 
number  of  cases  is  to  some  extent  due  to  their  having  in  the  course 
of  their  lives  been  more  exposed  to  continued  or  successive  infection. 

Contagion  does  not  occur  in  byres  unless  as  the  result  of  the 
presence  of  animals  with  open  tuberculous  lesions,  such  as  caverns 
in  the  lungs,  tuberculous  bronchitis  with  ulceration  of  the  mucous 
membrane,  tuberculous  metritis,  enteritis,  etc.  The  virulent  germs 
are  expelled  in  the  saliva,  nasal  discharge,  excrement,  etc.,  and  are 
distributed  over  the  forage,  manure,  litter,  and  in  the  drinking  water ; 
after  desiccation  they  may  be  spread  by  currents  of  air. 

The  mangers,  racks,  drinking  pails,  and  various  stable  utensils 
become  permanently  contaminated,  the  air  of  the  cow-sheds  contains 
virulent  dust,  and  the  animals  there  confined  are  continually  exposed 
to  infection  either  through  the  respiratory  or  digestive  passages. 

Contamination  through  the  respiratory  tract  is  by  far  the  most 
frequent  cause  of  the  evil,  and  recent  experiments  at  Pouilly-le-Fort 
(1900)  have  shown  how  easy  it  is  to  convey  the  disease  experimen- 
tally by  inhalation. 

Patients  suffering  from  closed  tuberculous  lesions  of  the  pleura, 
pericardium,  spleen,  peritoneum,  etc.,  do  not  spread  the  bacilli. 
Healthy  animals  may  remain  in  contact  with  them  without  danger, 
but  it  is  well  to  remember  that  such  cases  are  quite  exceptional. 
As  a  rule  the  lesions  are  of  a  mixed  character,  and  the  general 
principle  may  be  laid  down  that  cohabitation  of  any  duration  with 
tuberculous  subjects  is  dangerous. 

Contagion  spreads  more  easily,  in  proportion  to  the  number  of 
tuberculous  subjects  in  a  given  byre,  to  the  total  number  of 
animals  m  a  herd,  and  to  the  neglect  of  cleanliness,  good  feeding, 
ventilation,  etc. 

Life  in  the  open  air  and  at  grass  greatly  diminishes  the  chances 
of  contagion.  The  virulent  products  are  then  disseminated  in  all 
directions  and  are  soon  destroyed  by  the  general  atmospheric  con- 
ditions. Close  confinement  in  ill-ventilated  stables,  on  the  contrary, 
strongly  tends  to  the  propagation  and  development  of  tuberculosis. 

In  calves  infection  may  occur  through  the  alimentary  tract  by 
means  of  tuberculous  milk,  whether  such  milk  is  obtained  directly 
from  the  udder  or  out  of  a  pail.  The  same  may  be  true  of  young 
pigs  fed  with  skimmed  milk. 

Goats    contract   tuberculosis    somewhat   readily   by  confinement   in 


TUBERCULOSIS.  685 

byres  with  tuberculous  cows,  and  Moussu  declares  that  contagion 
afterwards  spreads  just  as  rapidly  among  goats  as  among  cows.  The 
vaunted  great  resistance  of  goats  to  tuberculosis,  formerly  so  often 
spoken  of,  and  by  some  wrongly  considered  as  a  condition  of  immunity, 
is  deceptive,  and  if  tuberculosis  is  less  frequently  seen  in  goats,  this  is 
solely  because  goats  enjoy  the  greatest  liberty  at  all  seasons. 

On  the  other  hand,  the  disease  is  very  rarely  conveyed  to  sheep, 
even  when  they  are  kept  for  long  periods  with  tuberculous  cows. 
Moussu  found  that  two  3'ears  of  close  cohabitation  were  necessary 
for  its  development  under  these  conditions. 

Heredity  is  a  factor  of  the  highest  importance  in  determining  the 
causation  of  tuberculosis.  At  the  present  time  a  tendency  exists  to 
deny  this,  but  such  a  view  is  erroneous. 

Observation  has  clearly  shown  that  tuberculosis  is  rarely  con- 
veyed from  the  mother  to  the  foetus,  and  that  practically  none  of 
the  calves  borne  by  tuberculous  mothers  react  to  tuberculin  (95  per 
cent^  :  Nocard  and  Bang)  ;  but  even  if  this  is  absolutely  correct,  it 
only  shows  that  great  benefits  might  be  derived  if  proper  sanitary 
organisation  and  intelligent  hygienic  conditions  in  byres  were  found 
everywhere  in  the  country.  Unfortunately  in  practice  this  is  far 
from  being  the  case.  These  non-tuberculous  calves  are  left  in  com- 
mon contaminated  byres,  where  they  rapidly  become  infected  and 
perpetuate  the  disease. 

Physiologically  these  facts  are  easily  explained.  The  placenta 
resists  the  passage  of  microbes,  or  at  least  only  allows  them  to  pass 
under  quite  exceptional  conditions,  and  practically  only  when  the 
blood-vessels  are  affected.  As,  on  the  other  hand,  tuberculosis  of 
the  ovaries,  Fallopian  tubes  or  uterus  generally  prevents  pregnancy 
and  causes  sterility,  there  is  nothing  extraordinary  in  the  fact  that 
tuberculosis  is  not  hereditary  in  the  strict  sense  of  the  term.  The 
influence  of  the  sire  has  been  invoked,  but  it  has  been  proved  that 
direct  paternal  infection  is  only  possible  where  ulcerating  tuberculous 
lesions  of  the  testicle,  prostate,  or  vesiculae  seminales  exist.  Such 
conditions  seldom  or  never  occur  in  the  sires  of  domestic  animals. 
As  a  general  rule,  therefore,  it  may  be  said  that  tuberculosis  is 
not  hereditary.  New-born  animals  become  infected  during  the  months 
following  birth,  either  directly  through  the  alimentary  tract  when  the 
mothers  are  suffering  from  mammary  tuberculosis,  or,  perhaps  more 
frequently,  through  the  respiratory  and  digestive  tracts. 

But  although  microbic  infection  is  not  hereditary,  it  by  no  means 
follows  that  the  offspring  of  tuberculous  subjects  are  as  well  prepared 
for  the  struggle  of  life  as  the  descendants  of  healthy  subjects.  "What 
is  transmitted  is  a  greater  tendency  to  contract  the  disease. 


6S6  INFECTIOUS    DISEASES. 

This  aptitude  or  predisposition  is  of  such  importance  that  in 
Moussu's  opinion  it  should  be  regarded  as  one  of  the  essential  factors 
in  the  development  of  tuberculosis.  The  cause  of  tuberculosis  is 
Koch's  bacillus.  It  does  not  alwaj's  produce  its  full  effects  in  animals 
born  of  healtliy  parents ;  but  in  one  that  suft'ers  from  a  tuberculous 
hereditary  taint  tuberculosis  appears. 

Physiological  and  pathological  researches  cast  considerable  light 
on  this  question.  In  tuberculous  mothers  the  organism  not  only 
suffers  from  the  infection,  but  from  a  permanent  intoxication  which 
interferes  with  normal  metabolism  in  the  vital  organs  and  the  ex- 
changes between  mother  and  foetus.  If  the  microbes  remain  confined 
to  the  system  of  the  mother,  their  poisons  are  conveyed  by  the  blood 
and  pass  through  the  placental  barrier.  In  a  greater  or  less  degree 
they  saturate  the  tissues  of  the  little  creature  in  process  of  develop- 
ment, and  communicate  to  it  a  peculiar  hereditary  taint.  The  effects  of 
this  taint  are  often  noticeable  from  the  moment  of  birth,  for  com- 
parative physiological  and  pathological  investigations  have  shown  "that 
the  tissues  of  tuberculous  animals  assimilate  given  foods  less  perfectly 
and  are  the  seat  of  greater  losses  of  all  kinds  than  those  of  healthy 
subjects. 

Although  the  disease  itself,  therefore,  is  not  hereditary,  it  is  other- 
wise with  the  organic  taint  which  plays  so  important  a  part  in  its  de- 
velopment. This  organic  taint  consists  in  a  special  condition  of  the 
tissues  or  cells  of  the  parents,  which  show  a  diminished  power  of 
resistance  to  the  action  of  the  germs  of  tuberculosis  ;  it  is  therefore 
easy  to  understand  how  important  a  part  these  influences  may  play 
under  certain  conditions. 

Without  doubt,  in  the  case  of  bovine  animals,  the  predisposition 
could  be  neutralised  in  carefully  managed  studs  by  the  immediate 
isolation  of  the  new-born  under  conditions  which  shield  them  from 
tuberculous  infection,  and  experiment  has  shown  the  benefits  derived 
from  such  precautions  ;  but  it  must  not  be  forgotten  that  intelligently 
managed  studs  are  the  exception,  and  that  for  a  long  time  to  come 
we  must  in  practice  take  cognisance  of  the  actual  conditions  under 
which  the  disease  develops. 

The  lesions  of  tuberculosis  vary  greatly  in  appearance,  according 
to  the  organs  affected,  though  the  method  of  development  is  always 
identical. 

The  primary  lesion  corresponds  to  what  has  been  termed  tuber- 
culous granulation,  or  anatomical  tubercle  properly  so  called ;  this, 
the  macroscopical,  pathological  entity,  assumes  the  form  of  a  small 
prominent  centre,  semi-transparent,  greyish,  opaque  or  yellowish,  ac- 
cording to  its  age. 


TUBERCULOSIS.  687 

These  tubercles,  produced  by  the  presence  of  colonies  of  bacilli, 
are  due  to  the  defensive  reaction  of  the  invaded  tissues,  which  gradu- 
ally undergo  change  and  are  destroyed  in  a  direction  radiating  from 
the  centre  towards  the  periphery.  The  tubercle  in  itself  has  no  very 
specific  character — only  the  bacillus. 

The  elementary  lesion  may  remain  isolated,  but  very  frequently 
it  is  closely  surrounded  by  other  similar  tubercles,  and  becomes 
enveloped  in  a  common  inflammatory  area.  A  large  portion  of  an 
organ  ,may  appear  as  if  riddled  with  tubercles  of  different  age  and 
size,  while  the  interstitial  connective  tissue  reacts  and  forms  fibrous 
separating  partitions.  The  general  appearance  is  that  described  under 
the  term  "  diffuse  tuberculous  infiltration." 

At  a  still  more  advanced  stage  in  the  development  of  the  disease 
conglomerations  are  produced,  consisting  of  tuberculous  masses  the 
size  of  a  hazel-nut,  a  walnut,  an  egg,  a  man's  fist,  or  even  larger. 
These  lesions,  irrespective  of  size,  undergo  caseous  degeneration  from 
the  centre  towards  the  periphery. 

In  exceptional  cases  the  tubercles  remain  fibrous.  More  frequently, 
particularly  in  animals  of  the  bovine  species,  they  become  infiltrated 
with  lime  salts.  Caseous  degeneration  not  only  invades  the  centre  of 
the  tubercles  but  also  the  peripheral  layers,  and  sometimes  the  whole 
of  a  conglomerated  mass. 

Steadily  pursuing  their  course  of  pathological  development,  the 
tuberculous  masses  become  softened  and  are  transformed  into  tuber- 
culous abscesses,  which  open  towards  any  free  passage,  leaving  behind 
sometimes  ulcerations,  sometimes  caverns  of  varying  sizes,  or  blind 
simple  or  bifurcated  fistulpe. 

Eecent  experiments  by  Nocard  and  Eossignol  (1900)  prove  con- 
clusively that  a  certain  time  (ahvays  more  than  a  fortnight)  elapses 
between  the  moment  of  entry  of  the  contagion  into  the  organism 
and  that  at  which  its  effects  become  manifest  by  furnishing  a 
reaction  to  tuberculin.  Calcification  or  softening  of  the  lesions, 
moreover,  never  occurs  in  less  than  fifty  days. 

According  to  the  organs  studied,  these  tuberculous  lesions  assume 
certain  appearances,  which  in  each  locality  seem  almost  always  to  be 
identical. 

Thus,  as  regards  the  larynx,  trachea,  and  bronchi,  the  tubercles 
develop  in  the  depths  of  the  mucous  membrane,  rapidly  undergoing 
caseous  transformation,  softening  and  purulent  degeneration,  and  pro- 
ducing numerous  isolated  or  confluent  ulcerations  in  the  air  passages. 
According  to  the  case  and  the  kind  of  animal  affected,  the  lung 
presents  either  disseminated  tuberculous  formation,  tuberculous  in- 
filtration, tuberculous  conglomeration,  or  cavern  formation. 


688  INFECTIOUS    DISEASES. 

The  lung  may  be  affected  to  such  a  degree  that  it  appears  incredible 
that  the  blood  can  have  been  sufficiently  aerated  to  support  life. 

The  lungs  may  be  transformed  into  yellowish,  caseous,  calcareous,  or 
softened  masses  enveloped  in  thick,  fibrous,  resistant  walls.  The  inter- 
vening pulmonary  tissue  may  be  healthy  in  appearance,  or  reddened, 
congested,  and  sometimes  hepatised. 

The  pleural,  pericardial,  and  peritoneal  membranes  may  be  covered 
with  exuberant  tuberculous  lesions,  like  ripe  mulberries,  in  consequence 
of  fusion  and  massing  of  the  tuberculous  growths.  The  primary 
tubercles  are  surrounded  with  fibrous  walls,  which  granulate  when 
on  the  surface  of  a  serous  membrane,  and  impart  to  the  membrane  a 
vegetative,  sometimes  villous  appearance,  and  a  colour  varying  from 
pink  to  light  or  dark  red. 

The  collective  lesions  lining  the  cavities  are  described  by  butchers 
under  the  significant  term  of  "grapes."  In  tlie  interior  of  these  exu- 
berant masses,  which  sometimes  form  layers  an  inch  or  more  in  thick- 
ness, the  tuberculous  lesions  undergo  the  usual  developmental  changes, 
that  is  to  say,  they  become  caseated  or  infiltrated  with  lime  salts,  but 
they  do  not  so  readily  undergo  softening  as  those  of  the  lung.  The 
parietal  and  visceral  serous  membranes  readily  become  adherent  at 
numerous  points,  setting  up  union  between  the  lung  and  the  walls  of 
the  chest,  or  the  intestine  and  the  walls  of  the  abdomen,  etc. 

In  the  pericardium  the  vegetations  are  frequently  of  a  fungoid 
character. 

Tuberculosis  of  lymphatic  glands  sometimes  assumes  a  disseminated, 
discrete  form  or  that  of  a  diffuse  infiltration,  or,  again,  in  old-standing 
cases  it  constitutes  a  massive  tuberculous  conglomeration.  In  point 
of  fact,  the  lymphatic  glands  as  such  no  longer  exist,  their  tissue 
having  undergone  total  degeneration ;  they  are  represented  only  by 
an  enlarged,  thick,  fibrous  shell,  forming  the  envelope  which  encloses 
caseated  and  calcareous  masses  of  a  more  or  less  soft  nature. 

Tuberculous  infiltration  of  the  sub-maxillary  and  sub-parotideal  lym- 
phatic glands  interferes  with  swallowing  and  breathing,  compresses  the 
pharynx,  oesophagus  and  larynx,  and  deforms  the  head. 

Compression  of  the  arteries,  veins,  nerves,  etc.,  at  the  entrance  to 
the  chest  may  cause  various  symptoms  which  are  not  difficult  to  inter- 
pret. The  glands  at  the  entrance  to  the  chest  and  the  whole  of  the 
anterior  mediastinum  may  form  a  single  mass.  Lesions  in  the  pos- 
terior mediastinum,  however,  are  of  even  greater  importance  and 
explain  certain  symptoms,  such  as  difficulty  in  swallowing,  spasm 
of  the  oesophagus,  mechanical  contraction  of  the  oesophagus,  perma- 
nent tympanites,  etc.,  for  which  the  state  of  the  lungs  alone  would 
not  account. 


TUBERCULOSIS. 


689 


Even  when  the  hings  are  unaffected  it  may  happen  that  the  lym- 
phatic glands  of  the  mediastinum  (superior  or  inferior  oesophageal 
lymphatic  glands)  and  the  hronchial  lymphatic  glands  may  be  so 
diseased  that  the  oesophagus  is  completely  surrounded  and  compressed 
by  them,  and  its  function  thus  seriously  impaired  (Fig.  276). 

In  the  abdomen  the  mesenteric  glands  are  most  exposed  to  disease, 
and  when  infected  through  the  intestinal  tract  they  assume  the  form 
of  large  flattened  masses  arranged  along  the  mesentery. 

In  the  digestive  tract,  as  in  the  trachea  and  bronchi,  tuberculosis 
has  a  marked  tendency  to  assume  the  ulcerative  form.  Disseminated 
or  aggregated  tubercles  develop  in  the  thickness  of  the  mucous  mem- 
brane, and,  after  rapidly  softening,  become  ulcerated.     The  nature  of 


Fig.  276.— Tuberculosis  of  lymphatics.  PG,  Left  lung  ;  PD,  right  lung  ;  TT, 
tuberculous  oesophageal  lymph  glands;  A,  aorta;  ffi,  oesophagus  (the  lung 
is  divided  transversely  near  its  centre). 


these  lesions  can  only  be  determined  by  noting  their  character  and 
examining  the  discharge. 

The  ulcerations  are  localised  in  the  mouth  and  pharynx,  in  the  second 
half  of  the  small  intestine  towards  the  ileum,  and  in  Peyer's  patches. 

Tuberculous  lesions  develop  in  the  vaginal  sheath  of  the  male  genital 
organs  exactly  in  the  same  way  as  in  an  ordinary  closed  serous  cavity ; 
tubercles  may  also  develop  on  the  surface  or  in  the  substance  of  the 
testicle.  They  become  aggregated,  undergo  softening,  spread  towards 
the  interior,  and  may  break  down,  thus  forming  abscesses.  In  the 
female  genital  passages  the  disease  invades  the  thickness  of  the  walls, 
but  shows  a  marked  tendency  to  ulceration,  as  in  the  intestine  or 
trachea. 

In  the  udder  tuberculosis  is  generally  diffuse,  shows  a  tendency 
to  hypertrophy  and  the  free  formation  of  fibrous  or  sclerous  tissue ; 
only  tubercles  in  the  glandular  layer  of  the  acini  become  ulcerated. 
In  time  the  whole  of  the  secreting  structure  undergoes  diffuse  tuber- 
culous suppuration,  fibro-caseous  masses  form  in  the  depths  of  the  tissue 
and  may  soften,  producing  deep-seated  tuberculous  "  cold  abscesses." 
D.c.  Y  y 


690  INFECTIOUS    DISEASES. 

The  mammary  lymphatic  glands  are  affected  in  the  same  way  as  other 
lymphatic  glands. 

In  the  joints  tubercles  appear  either  on  the  synovial  membrane  or 
in  the  thickness  of  the  bony  epiphyses,  very  often  at  both  points  simul- 
taneously. The  synovial  membrane  is  covered  with  vegetations  and 
villous  growths,  the  ends  of  the  bones  are  attacked  by  a  destructive 
ostitis,  tubercles  or  tuberculous  centres  form  in  the  thickness  of  the 
spongy  tissue,  the  articular  cartilages  are  destroyed,  the  ends  of  the 
bones  become  deformed,  and  in  the  last  stages  fungoid  arthritis  in 
various  forms  may   be  produced. 

In  bones  the  tubercles  originate  in  the  depths  of  the  spongy  tissue. 
They  produce  destructive  hypertrophic  ostitis,  in  which  the  bony  tissue 
is  replaced  by  tuberculous  centres  or  masses  divided  by  fibrous  parti- 
tions. On  section,  these  lesions  exhibit  the  same  yellowish  caseated 
or  calcified  appearance  as  the  lesions  of  other  affected  organs.  The 
compact  layer  may  sometimes  be  perforated  at  several  points  before 
being  destroyed. 

In  tuberculosis  of  the  brain  the  primary  lesions  develop  at  the 
expense  of  the  serous  layers  of  the  arachnoid  and  on  the  pia-mater, 
towards  the  base  of  the  brain  and  the  fissure  of  Sylvius,  or  at  the 
expense  of  the  small  vessels  which  penetrate  the  depths  of  the  nerve 
substance  itself.  Some  tubercles  remain  isolated,  become  confluent  or 
are  collected  in  masses  of  different  sizes,  and  provoke  symptoms  which 
vary  with  the  locality  attacked. 

Symptoms.  Tuberculosis  is  the  most  protean  of  all  diseases,  and 
at  first  sight  it  often  seems  impossible  to  assign  to  one  group,  clinical 
conditions  presenting  such  essentially  different  appearances.  All  the 
tissues  may  be  attacked,  from  the  bones  to  the  most  delicate  of  the 
viscera,  a  fact  which  explains  why  all  aspects  of  tuberculosis  cannot 
be  described.  Certain  forms,  however,  occur  very  frequently,  and 
may  be  regarded  as  classic;  these  will  be  considered  in  the  order  of 
their  frequency. 

TUBERCULOSIS    OF     THE     RESPIRATORY    APPARATUS. 

Without  doubt  this  form  of  tuberculosis  is  by  far  the  most  fre- 
quent. It  assumes  the  form  either  of  bronchitis,  laryngo-bronchitis, 
or  pulmonary  tuberculosis. 

Tuberculous  Bronchitis. — The  symptoms  of  tuberculous  bronchitis 
do  not  essentially  differ  from  those  of  ordinary  bronchitis,  though  the 
disease  develops  more  insidiously  and  slowly,  and  is  seldom  accom- 
panied by  fever.  At  first  the  cough  is  dry  and  suppressed  ;  later  it 
becomes  paroxysmal,  and  at  a  still  more  advanced  period  liquid  and 


TUBERCULOSIS   OF   THE   RESPIRATORY   APPARATUS.  691 

rough.  The  least  irritation  brings  on  these  attacks  of  coughing  ; 
changes  from  the  warmth  of  the  stable  to  the  coldness  of  the  outer 
air  or  rice  versa,  the  presence  of  dust  or  the  action  of  liquids  when 
drinking,  etc.,  etc.  During  the  first  stage  coughing  is  not  followed 
by  expectoration,  but  later  yellowish-grey,  glairy  mucus  may  be  dis- 
charged :  more  frequently  it  is  coughed  into  the  pharynx  and  swallowed. 

These  symptoms  continue  for  weeks  or  months  without  showing 
any  tendency  to  abate.  If  the  larynx  is  attacked  inspiration  becomes 
rattling  and  difficult,  while  the  neck  and  head  are  held  extended,  and 
the  least  pressure  over  the  larynx  produces  coughing. 

Tuberculosis  of  the  larynx,  trachea,  and  bronchi  is  usually  accom- 
panied by  disease  of  the  lung,  but  may  occur  by  itself. 

When  there  is  a  discharge  it  consists  of  thick,  viscous,  sticky 
mucus  of  a  peculiar  greyish-yellow  colour.  Microscopical  examination 
shows  it  to  contain  tuberculous  bacilli. 

Pulmonary  Tuberculosis  usually  assumes  the  chronic  form,  and  is 
almost  always  preceded  by  specific  bronchitis.  The  patients  retain 
their  appearance  and  condition  for  a  longer  or  shorter  time,  and, 
without  the  experience  resulting  from  continued  observation,  it  would 
be  difficult  to  believe  them  to  be  suffering  from  the  slow  development 
of  a  serious  disease. 

Frequent  coughing  without  any  apparent  reason  is  the  only  symptom 
likely  to  arouse  suspicion. 

At  a  later  stage  these  animals  lose  condition,  feed  less  eagerly  or 
exhibit  capricious  appetite,  and  sometimes  well-marked  and  repeated 
digestive  disturbance,  such  as  slight  tympanites  with  constipation  or 
diarrhoea,  moderate  impaction  of  the  rumen,  relative  atony  and 
slackening  of  peristaltic  movements.  The  wasting  gradually  becomes 
more  marked  or,  in  the  case  of  pregnant  or  milch  cows,  makes 
intermittent  progress,  until  the  animals  become  ansemic  and  finally 
cachectic.  The  cough  is  more  frequent  and  more  severe,  and  is 
followed  by  discharge  from  the  nose  or  by  swallowing  movements. 
From  this  time  phthisis,  properly  so  called,  exists. 

The  course  of  the  disease  is  not  invariable.  Certain  animals  may 
appear  ill  for  years  without  clinically  showing  the  least  apparent 
aggravation ;  others  on  the  contrary,  though  living  under  similar 
conditions,  are  rapidly  attacked,  and  in  six  to  twelve  months  exhibit 
all  the  signs  of  advanced  phthisis.  Pregnancy,  suckling,  and  pro- 
longed lactation  favour  the  development  of  the  disease  by  taxing 
the  physical  resources  of  the  animal. 

Animals  suffering  from  phthisis  exhibit  a  pecuhar  appearance. 
They  are  extremely  thin,  all  their  soft  tissues  are  wasted,  the  Hmbs 
are   dragged   in   moving,    respiration   is   rapid   and    sometimes    jerky, 

Y  Y  2 


692  INFECTIOUS   DISEASES. 

the  mucous  membranes  are  pale  and  discoloured,  and  the  skin  is 
tight  and  adherent  to  the  subjacent  tissues. 

These  general  signs,  however,  would  not  warrant  a  diagnosis,  for, 
apart  from  the  cough,  certain  other  diseases  present  all  the  external 
appearances  of  the  last  period  of  tuberculosis  (chronic  diarrhoea, 
chronic  forms  of  poisoning — bacterial  or  otherwise — dyspepsia,  etc.). 

In  cases  of  doubt  it  is  essential  to  discover  by  percussion  and 
auscultation  that  the  external  signs  are  really  the  result  of  lesions 
of  the  lung,  and  that  the  lung  disease  has  developed  gradual!}^  in 
accordance  witli  the  signs  shown  b}'  simple  external  inspection. 

The  symptoms  presented  during  the  development  of  the  pulmonary 
lesions  may  be  divided  into  three  phases. 

In  the  first  phase  percussion  gives  no  information,  though  auscul- 
tation reveals  rough  respiration,  inspiration  and  expiration  being 
also  unequal.  Expiration,  which,  in  the  healthy  subject,  is  silent, 
becomes  clearly  perceptible,  not  over  the  whole  lung,  but  usually  over 
the  anterior  lobes,  particularly  the  cardiac  lobes.  This  sign  is  the 
result  of  tuberculous  infiltration  and  of  the  neighbouring  pulmonary 
tissue  having  lost  its  elasticity. 

Inspiration  is  rough  and  rasping,  and  sometimes  occurs  in  several 
stages,  the  act  being  interrupted  or  jerky ;  expiration  lasts  longer 
than  inspiration,  is  rough  and  prolonged,  but  never  blowing  in 
character.  These  peculiarities  are  only  found  in  one  other  condition 
of  the  lung,  viz.,  emphysema. 

The  patients  appear  little  affected  in  this,  the  first,  stage  of  tuber- 
culosis.    But  for  the  cough  they  may  seem  perfectly  healthy. 

In  the  second  phase  the  tuberculous  infiltration  extends  and  ends 
in  the  massing,  by  fusion  or  centrifugal  growth,  of  the  tuberculous 
masses. 

Percussion  may  now  indicate  localised  dulness,  but  this  is  not 
invariable,  because  the  diseased  anterior  and  middle  lobes  of  the 
lung  are  concealed  beneath  the  muscles  of  the  shoulder.  When 
dulness  is  noted,  it  is  usually  over  the  lower  part  of  the  posterior 
lobes,  very  rarely  at  any  higher  point  on  the  side  of  the  chest. 
Frequently  the  dulness  is  only  partial. 

On  auscultation  the  signs  met  with  during  the  first  stage  become 
much  more  marked.  Inspiration  is  always  rough,  rasping,  painful 
and  difficult  at  certain  points,  particular!}'  in  the  anterior  zones. 
In  this  region  expiration  is  rough,  prolonged  and  sometimes  of  a 
clearly  marked  blowing  character.  This  is  particularly  the  case  in 
the  sub-scapular  zone  and  the  auscultation  zones  2  and  3  (Fig.  166). 
In  the  dorsal  region  and  in  zone  No.  1,  respiration  may  appear 
normal.     Nevertheless,   the   sounds  are  propagated  to  a  distance,  the 


TUBERCULOSIS   OF   THE   RESPIRATORY   APPARATUS.  693 

infiltrated  lung  steadily  loses  its  elastic  qualities,  the  vesicular  murmur 
entirely  disappears  from  the  affected  regions,  and  the  sounds  noted  are 
of  bronchial  origin. 

Like  the  first,  the  second  phase  may  vary  in  intensity,  extent, 
and  in  the  diffusion  or  localisation  of  the  tuberculous  lesions. 
Blowing  respiration  may  be  noted  over  different  areas,  accompanied 
by  sibilant,  snoring  and  migratory  mucous  rales.  The  vesicular 
murmur  is  exaggerated  in  the  healthy  parts,  coughing,  accompanied 
by  expectoration  or  followed  by  swallowing  movements,  is  frequent, 
the  appetite  becomes  capricious,  and  the  general  condition  suffers. 
In  this  second  phase  almost  the  whole  of  one  lung  may  be  diseased 
and  exhibit  the  signs  described. 

The  third  phase  corresponds  to  the  softening  of  the  tuberculous 
masses,  and  the  formation  of  ulcers  and  caverns.  The  zones  of 
dulness  or  partial  dulness  may  be  more  extensive,  though  cavern 
formation  is  usually  confined  to  the  anterior  or  middle  lobes.  Per- 
cussion still  affords  no  precise  information.  ' 

As  the  tuberculous  masses  undergo  softening  and  ulceration, 
their  contents  are  gradually  passed  into  the  bronchi,  and  ausculta- 
tion reveals  signs  indicative  of  the  existence  of  caverns,  which  signs 
vary  with  the  dimensions  of  the  caverns  themselves.  On  ausculta- 
tion the  respiration  is  always  found  to  have  at  certain  points  a 
blowing  character,  and  it  may  even  develop  into  a  true  tubal  souffle. 
In  other  areas,  where  the  caverns  are  merely  in  course  of  formation, 
gurgling  sounds  are  all  that  are  heard,  but  where  true  caverns 
exist  there  is  an  incessant  cavernous  soufffe. 

The  lesions  peculiar  to  the  third  phase  are  seldom  seen  in  prac- 
tice; because  the  animals  become  anaemic,  exhausted  and  cachectic, 
they  are  usually  slaughtered  early.  Nevertheless,  the  third  stage  occa- 
sionally develops  in  an  astonishingly  short  time,  six  to  eight  months 
at  m'ost. 

Very  frequently  the  patients,  although  cachectic  and  even  phthisical, 
do  not  yield  on  auscultation  the  sounds  described  as  peculiar  to  the 
third  stage,  because  the  tendency  to  softening  is  not  very  marked  in 
bovine  animals.  The  lungs  exhibit  massive  infiltration,  and,  whilst 
pulmonary  consumption  is  not  uncommon,  the  development  of  caverns 
is  comparatively  rare. 

The  expectoration  or  discharge  in  this  third  form  is  puriform, 
glairy,  viscous,  and  of  a  dirty-yellow  or  even  greenish-yellow  colour. 
Bacteriological  examination  reveals  the  presence  of  tubercle  bacilli 
and  adventitious  organisms. 

These  conditions  are  always  associated  with  various  complications, 
and  the  second  and  third  stages  of  chronic  tuberculosis  are  frequently 


694  INFECTIOUS    DISEASES. 

accompanied  by  lesions  of  the  pleura,  of  the  mediastinal  lymphatic 
glands,  of  the  liver,  etc. 

Digestive  disturbances  often  occur ;  the  appetite  is  capricious  or 
in  abeyance,  there  is  atony  of  the  rumen  and  chronic  dyspeptic 
tympanites.  These  disturbances  are  easily  understood  where  there 
are  lesions  of  the  liver,  intestine,  and  mesenteric  lymphatic  glands, 
but  not  when  the  lung  alone  appears  the  seat  of  the  disease.  In 
this  condition  the  patients  probably  suflfer  from  permanent  complex 
intoxication,  due  to  toxins  elaborated  by  the  tubercle  bacillus  and 
other  microbes  which  multiply  on  or  in  the  lesions,  and  this  chronic 
intoxication  reacts  on  the  vital  functions  (innervation,  secretion, 
digestion  and  nutrition).  Nor  are  the  effects  limited  to  these  appear- 
ances ;  the  heart's  action  is  also  accelerated,  and  the  temperature 
rises.  During  the  first  and  part  of  the  second  phase  there  is  com- 
paratively little  fever,  but  afterwards  this  is  continuous  or  of  a 
peculiar  intermittent  character.  In  the  morning  the  patient's 
temperature  may  be  normal;  in  the  evening  it  has  risen  from 
1'5  to  as  much  as  9*^  Fahr.  (1'1°  to  5*2°  C.)  above  normal,  and 
this  recurs  day  by  day.  These  attacks  coincide  with  softening  of  the 
lesions,  and  when  suppurating  caverns  exist  they  are  more  marked 
and  more  nearly  continuous,  assuming  the  characters  of  the  hectic 
fever  shown  in  consumption. 

Often  during  the  febrile  periods  the  urine  is  albuminous. 

In  chronic  tuberculosis  of  bovine  animals  bleeding  from  the  lung 
is  rare  even  when  caverns  exist,  and  Moussu,  in  spite  of  extensive 
experience,  has  seen  only  two  cases.  This  is  in  striking  contrast  with 
the  condition  in  human  sufferers  from  pulmonary  tuberculosis,  two- 
thirds  of  whom  bleed  at  the  lungs. 


TUBERCULOSIS     OF     SEROUS     MEMBRANES. 

After  pulmonary  tuberculosis,  tuberculosis  of  the  pleural  and  peri- 
toneal serous  membranes  is  the  most  frequent  clinical  form  of  this 
disease.  Sometimes  both  forms  exist,  and  although  the  pleural  and 
peritoneal  lesions  predominate  or  alone  attract  attention,  there  are 
also  lesions  in  the  lung  or  mediastinal  lymphatic  glands. 

It  is  difficult  to  explain  how  the  pleural  and  peritoneal  serous 
membranes  can  l)e  seriously  invaded  without  the  lung  becoming 
affected,  though  in  point  of  fact  such  a  state  of  things  frequently 
exists. 

Tuberculosis  of  the  pleura  without  pulmonar}'  lesions  is  suggested 
by  very  obscure  symptoms.  The  general  signs  consist  in  diminution 
of   appetite,  loss   of   condition,   tachycardia,  elevation   of   temperature, 


TUBERCULOSIS    OF    SEROUS    MEMBRANES.  695 

and  progressive  organic  wasting.  These  are  always  j^resent,  though 
in  themselves  they  have  no  specific  significance. 

The  local  symptoms  are  still  more  vague.  Percussion  causes  pain, 
and  the  practitioner  might  at  first  suspect  peri-pneumonia.  The 
patient  edges  away,  and  tries  to  avoid  the  application  of  the  plexi- 
meter  hammer.  Firm  pressure  over  the  intercostal  spaces  sometimes 
causes  struggling,  and  produces  indications  of  abnormal  sensitiveness. 
There  is  generally  extensive  partial  dulness,  sometimes  complete  dul- 
ness  towards  the  lower  regions  of  the  chest. 

On  auscultation  the  lung  may  reveal  the  difi'erent  indications  of 
chronic  pulmonary  tuberculosis,  or  simply  diminution  of  the  respira- 
tory murmur  at  points,  accompanied  by  crepitant,  sibilant  rales,  and 
moist,  crackling  sounds.  As  the  anterior  portions  of  the  pleural  sacs 
are  most  commonly  invaded,  the  anterior  vena  cava  is  compressed, 
causing  some  difficulty  in  the  return  circulation,  and  producing  venous 
pulse,  which  may  extend  as  high  as  the  parotid  gland;  there  is,  how- 
ever, no  swelling  of  the  dewlap. 

Respiration  is  frequent  and  difficult  in  consequence  of  adhesions 
between  the  pleura  and  lungs,  which  are  connected  by  bands  of 
fibrous  tissue  of  varying  extent.  Coughing  is  rarely  absent,  and  if  the 
lung  is  diseased  may  be  followed  by  discharge  containing  numerous 
bacilli.  Otherwise  the  cough  exhibits  the  pleuritic  character,  that 
is,  it  remains  slight,  dry,  paroxysmal,  and  painful.  The  pericar- 
dium may  be  affected  as  well  as  the  pleura;  if  the  conditions  occur 
simultaneously  the  venous  pulse  in  the  jugulars  will  be  particularly 
apparent. 

The  symptoms  of  tuberculous  pericarditis  are  similar  to  those  of 
ordinary  pericarditis,  except  that  the  exudation  is  less  abundant ;  in 
a  word,  the  symptoms  are  those  of  rather  trifling  exudative  peri- 
carditis. 

Tuberculosis  of  the  peritoneum  is  frequently  accompanied  by  that 
of  the  pleura  or  the  abdominal  viscera.  The  lesions  are  localised  on 
the  parietal  peritoneum  and  epiploon,  producing  in  time  adhesions 
between  the  viscera  and  walls  of  the  peritoneal  cavity,  which  afi'ect 
the  action  of  the  digestive  organs,  gradually  causing  interference  with 
the  peristaltic  movement  both  of  the  rumen  and  the  intestines.  The 
stagnation  of  alimentary  matter  favours  fermentation,  so  that  the 
rumen  becomes  permanently  distended.  The  right  flank  also  is 
swollen,  and  the  abdomen  exhibits  a  change  in  shape  similar  to  that 
in  peritonism,  which  is  a  constant  symptom  of  tuberculous  peritonitis. 

As  in  the  thorax,  the  tuberculous  lesions  seldom  produce  extensive 
liquid  exudation,  so  that  ascites  does  not  occur,  but  on  palpation 
the  abdominal  walls  appear  to  have  entirely  lost   their   pliability  and 


696  INFECTIOUS    DISEASES. 

to  be  unyielding   and    greatly  thickened,  a   point  which    is   the   more 
remarkable  as  the  animals  are  thinner. 

The  wall  of  the  abdomen  is  stiff,  incapable  of  being  depressed  as 
in  ordinary  subjects,  and  gives  to  the  fingers  the  sensation  of  a  thick 
hard  covering,  through  which  the  subjacent  organs  and  their  contents, 
that  is,  the  rumen,  intestine  and  alimentary  material,  can  no  longer 
be  felt.  This  rigidity  is  always  most  marked  in  the  lower  abdominal 
region.  The  digestive  peristaltic  movement  can  no  longer  be  detected, 
and  on  auscultation  the  normal  sounds  are  manifestly  much  slower 
than  usual. 

TUBEECULOSIS  OF  LYMPHATIC  GLANDS. 

It  might  perhaps  have  seemed  more  logical  to  place  tuberculosis  of 
the  lymphatic  glands  at  the  commencement  of  these  cjinical  divisions 
of  tuberculosis,  as  when  tuberculous  lesions,  of  whatever  kind,  occur 
in  the  lung,  pleura,  abdomen,  etc.,  the  lymphatic  glands  in  the  neigh- 
bourhood are  invariably  invaded.  In  such  cases,  however,  the  lesions 
in  question  are  not  the  dominant  features. 

Under  this  heading  must  be  classed  tuberculous  lesions  which,  on 
the  contrary,  affect  the  lymphatic  glands  in  so  marked  a  manner  that 
lesions  in  other  organs  may  be  regarded  as  secondary.  This  occurs 
somewhat  frequently,  because  at  the  present  day  there  is  a  tendency 
to  believe  that  inoculation  takes  place  mainly  through  the  mucous 
membrane  of  the  pharynx,  and  thence  extends  towards  the  neighbouring 
lymphatic  glands.  At  any  rate,  it  is  unquestionable  that  tuberculosis 
of  the  lymphatic  glands  may  exist  quite  apart  from  any  other  lesion 
visible  to  the  naked  eye. 

Two  forms  are  ver}^  common,  tuberculosis  of  the  retro-phaiyngeal 
region  and  of  the  neck,  and  tuberculosis  of  the  mediastinal  lymphatic 
glands. 

Tuberculosis  of  the  Retro-pharyngeal  Glands. — In  addition  to 
the  retro-pharyngeal  glands  the  cervical  chain  of  lymphatic  glands, 
the  sub-glossal,  sub-atloid,  pre-parotid,  and  even  the  pre-scapular 
lymphatic  glands  and  those  at  the  entrance  to  the  chest,  may  also 
be  invaded  more  or  less. 

This  form  of  tuberculosis  may  remain  latent  for  a  long  time,  atten- 
tion being  attracted  to  it  only  when  deglutition  is  impeded  and  local 
deformity  becomes  apparent. 

Swelling  of  lymphatic  glands  resulting  from  tuberculous  infection 
is  slow  and  progressive,  differing  entirely  from  that  which  accom- 
panies suppurative  adenitis.  The  neighbouring  connective  tissue  is 
certainly  somewhat  thickened  or  infiltrated,  but  the  glands  themselves 
can    always   be   detected.     The   region   of   the  gullet  is  enlarged,   th§ 


TUBERCULOSIS    OF    LYMPHATIC    GLANDS. 


697 


depression  marginating  the  lower  jaw  is  filled  up,  the  sub-atloid  space 
disappears,  the  sub-glossal  glands  occupy  the  space  beneath  the  tongue, 
and  in  cases  where  the  lesions  are  very  pronounced  the  cesophagus 
and  larynx  may  even  be  pushed  downwards. 

Swallowing  is  difficult,  in  consequence  of  compression  of  the  upper 
part  of   the   oesophagus,    and,   as   the 
laryngeal  nerves  may  be  included  in 
the  swelling,  dyspnoea  or  roaring  not 
uncommonly  results. 

By  palpation  with  one  or  both 
hands  it  is  easy  to  identify  the  glands 
and  detect  enlargement,  hardness  and 
sensitiveness.  In  exceptional  instances 
the  caseous  masses  they  contain 
undergo  softening  and  conversion  into 
purulent  material. 

When  the  cervical  lymphatic  glands 
are  attacked  the  jugular  furrows  dis- 
appear, and  the  whole  of  the  pre- 
tracheal and  lateral  regions  of  the 
neck  exhibit'  doughy  swellings. 

These  swellings  are  rarely  sym- 
metrical, a  fact  which  admits  of  this 
condition  being  distinguished  from 
lesions  due  to  lymphadenitis,  without 
examining  the  blood. 

The  prescapular  glands  are  rarely 
attacked,  but  those  at  the  entrance 
to  the  chest,  which  may  be  found  on 
either  side  of  the  trachea  by  passing 
the  fingers  between  the  two  first  ribs, 
are  frequently  enlarged  to  the  size  of 
a  fowl's  egg. 

Tuberculosis  of  the  Mediastinum. 
— Whenever  the  lungs  are  much  in- 
volved,  the  bronchial  glands  are   also 

invaded,  though  the  glands  of  the  anterior  and  posterior  mediastina 
may  escape.  On  the  other  hand,  the  mediastinal  glands  are  some- 
times much  involved,  whilst  the  lung  remains  intact. 

The  lymphatic  glands,  particularly  those  of  the  mediastinum,  may 
be  enormously  enlarged,  and  the  various  accidents  which  result  are 
due  as  much  to  mechanical  interference  with  the  functions  of  adjacent 
organs  as  to  the  lesions  themselves. 


Fig.  277. — Lesions  in  retro-pharyn- 
geal  tuberculosis.  T,  Trachea ; 
(E,  cesophagus  ;  P,  pharynx  ; 
H,  hyoid  bone  ;  E,  epiglottis ; 
L,  tongue  ;  G,  tuberculous  retro- 
jiharyngeal  glands. 


G98 


INFECTIOUS   DISEASES. 


When  the  glands  of  the  anterior  mediastinum  are  affected,  they 
cause  compression  of  tlie  anterior  vena  cava,  with  stasis  of  blood  in 
the  jugular  vein  and  venous  pulse,  then  compression  of  the  cesophagus 
and  trachea,  and  of  the 'nerves  at  the  entrance  to  the  chest,  producing 
difficulty  in  swallowing,  respiration  and  circulation. 

If,  as  often  happens,  the  glands  of  the  posterior  mediastinum  are 


Fig.  278. — Well-developed  tuberculosis  of  the  mediastinal  lymphatic  glands. 
PG,  Left  lung;  PD,  right  lung;  Q*],  oesophagus;  A,  posterior  aorta;  T, 
tuberculous  lymphatic  glands. 


affected  and  greatly  enlarged,  they  may  involve  the  oesophagus  and 
the  oesophageal  nerves,  interfere  with  deglutition  and  rumination,  and 
thus  produce  marked  disturbance.  The  animals  only  swallow  with 
difficulty,  and  later  rumination  becomes  impossible,  the  anti-peristaltic 
movement  not  being  powerful  enough  to  overcome  the  resistance. 
Soon  after  eating,  the  patients  exhibit  tympanites,  certainly  only  to 
a   moderate   extent,  but    the    swelling   is   long   in    disappearing.     This 


TUBERCULOSIS    OF   THE    DIGESTIVE    TRACT.  G99 

tympanites  is  due  to  the  difficulty  in  eructation  and  to  the  impossi- 
bility of  rumination.  The  contents  of  the  rumen  pass  slowly  towards 
the  intestine  until  the  onset  of  a  fresh  attack. 

On  account  of  digestive  difficulties,  the  animals  rapidly  lose  flesh, 
just  as  though  they  were  suffering  from  extensive  visceral  lesions. 


TUBERCULOSIS    OF    THE    DIGESTIVE    TRACT. 

Tuberculosis  of  the  digestive  tract  is  rarer  than  tuberculosis  of 
the  lungs  or  lymphatic  glands,  and  occurs  in  two  well-differentiated 
clinical  forms,  that  is  to  say,  tuberculosis  of  the  buccal  and  pharyngeal 
membrane  and  tuberculosis  of  the  intestines.  Tuberculosis  of  the  liver, 
which  is  less  easily  recognised,  is  indicated  by  signs  of  dyspepsia. 

Bucco-Pharyngeal  Tuberculosis. — This  may  be  primary  or  secon- 
dary, and  occurs  in  the  form  of  local  or  general  glossitis  or  superficial 
ulcerative  stomatitis. 

In  the  former  case  the  glossitis  may  be  regarded  as  due  to  actino- 
mycosis ;  in  the  latter  it  can  only  be  mistaken  for  simple  ulcerative 
stomatitis. 

It  is  accompanied  by  difficulty  in  mastication,  and  still  more,  where 
the  pharynx  is  invaded,  in  deglutition ;  abundant  frothy  salivation  in 
feeding ;  sometimes  by  true  spasm  of  the  pharynx  and  rejection  of 
masticated  balls  of  food. 

Locally  the  buccal  mucous  membrane  (cheeks,  tongue,  pillars  of 
the  fauces,  etc.)  exhibit  ulcerations,  with  festooned  borders,  in  size 
something  between  a  florin  and  a  five-shilling  piece,  covered  with 
a  greyish-yellow,  earthy-coloured  exudation  adhering  firmly  to  the  sub- 
jacent parts.  The  margin  of  the  ulceration  is  but  slightly  indurated, 
and  the  tongue  preserves  its  mobility,  except  in  cases  of  general 
deep-seated  glossitis. 

The  condition  may  continue  for  weeks  and  months  without  im- 
provement. 

Intestinal  Tuberculosis. — Tuberculous  enteritis  is  always  accom- 
panied by  tuberculosis  of  the  mesenteric  glands  and  of  the  sub-lumbar 
lymphatic  chain.  It  is  indicated  at  first  by  chronic  tympanites  and 
peritonism,  unaccompanied,  however,  by  atony  of  the  rumen ;  at  a 
later  period  by  intermittent  diarrhoea,  which  attains  a  maximum  and 
is  followed  by  constipation.  Finally,  when  there  exist  numerous  in- 
testinal ulcers,  the  diarrhcea  is  profuse  and  intractable,  the  animals 
rapidly  grow  exhausted,  and  the  disease  spreads  to  other  organs  with 
startling  rapidity. 

The  food  is  ill-digested  and  the  faeces  have  a  repulsive  odour,  as 
has  also  the  gas  which  escapes  from  the  rumen  when  it  is  punctured. 


700  INFECTIOUS  DISEASES. 


TUBERCULOSIS  OF  THE  GENITAL  ORGANS. 

In  males,  tuberculosis  may  attack  the  testicle  and  neighbouring 
organs  and  tissues ;    in   females,  the   ovary,   uterus,  vagina,  or  udder. 

Tuberculosis  of  the  testicle  is  rare.  Moussu  appears  only  to  have 
seen  one  case,  namely,  in  the  boar.  The  disease  produces  specific 
vaginitis  and  specific  orchitis,  the  serous  surfaces  of  the  vaginal  tunic 
becoming  adherent,  and  tubercles  forming  in  the  depths  of  the  tes- 
ticle, whilst  in  time  the  testicle  becomes  the  seat  of  fungoid  growths. 

Tuberculosis  of  neighbouring  glands  has  only  been  observed  in 
the  case  of  the  prostate.  Clinically  it  is  distinguished  by  symptoms 
which  suggest  difficulty  in  urination,  and  comprise  frequent  straining, 
efforts  to  micturate,  dysuria,  etc.  Examination  by  the  rectum  reveals 
changes  in  the  prostate,  but  affords  no  exact  information  as  to  their 
nature. 

Tuberculosis  of  the  genital  tract  in  the  female  is  usually  a  delayed  ■ 
complication  of  a  preceding  visceral  tuberculosis,  though  it  ma}"  occur 
as  a  primary  disease,  in  which  case  the  lesions  are  localised  about 
the  vulva  or  the  vagina.  Tuberculosis  of  the  ovaries.  Fallopian 
tubes,  ajid  uterus  is  much  more  common  than  that  of  the  two 
organs  just  mentioned.  It  seems  certain  that  the  disease  may  be 
transmitted  directly  from  the  male  to  the  female  l)y  copulation,  in 
cases  where  the  male  animal  has  a  lesion  on  the  penis. 

Tuberculosis  of  the  vulva  is  rarer,  and  is  indicated  l)y  swelling, 
sclerotic  changes,  and  the  presence  of  tuberculous  nodules,  varying  in 
size  between  a  lentil  and  a  hazel-nut ;  after  ulceration  of  these  growths, 
a  thick  yellowish  pus  containing  the  specific  bacilli  is  discharged. 

Tuberculosis  of  the  vagina  is  also  indicated  by  hardening  of  the 
walls,  sclerous  infiltration,  and  the  presence  of  deep-seated  tuber- 
>culous  nodules,  which  may  or  may  not  become  ulcerated.  It  may 
follow  uterine  tuberculosis,  the  discharge  from  the  uterus  continu- 
ally soiling  and  at  length  infecting  the  floor  of  the  vagina.  In 
such  eases  the  lower  wall  of  the  vagina  is  thickened  and  infiltrated 
to  a  greater  extent  than  the  roof,  and  is  sometimes  intersected  by 
transverse  ulcerated  suppurating  folds.  Bacteriological  examination 
reveals  the  presence  of  bacilli. 

Tuberculous  invasion  of  the  ovaries.  Fallopian  tubes,  and  uterus 
is  externally  indicated  by  signs  of  chronic  metritis  accompanied  by 
a  purulent  discharge,  which  may  or  may  not  be  foetid,  but  always 
possesses  special  characteristics.  The  neck  of  the  uterus  is  half 
open,  and  the  discharge  is  continuous.  The  pus  is  of  a  greyish- 
yellow  colour,  ill-formed,  grumous,  or  more  frequently  granular,  and 
it   sometimes   accumulates   in   large    quantities   in   the   depressions  of 


TUBERCULOSIS   OF   BONES   AND   ARTICULATIONS. 


701 


the  vagina.  Examination  by  means  of  the  speculum  is  of  great  vaUie 
in  diagnosing  such  lesions.  On  examining  the  parts  through  the 
rectum,  the  walls  of  the  uterus  are  found  to  be  greatly  thickened, 
sometimes  indurated,  bosselated  or  totally  deformed. 

The  Fallopian  tubes  and  ovaries  may  have  attained  enormous 
dimensions,  and  the  normal  anatomy  of  the  parts  is  greatly  altered 
both  as  regards  dimensions  and  relations. 

The   almost  inevitable   consequences  of   tuberculosis  of    the  genital 
organs    are    hypertrophy,    induration    or    caseation   of    the    subsacral 
and  sublumbar  lym- 
phatic glands. 

Udder.  —  Tuber- 
culosis of  the  udder 
may  be  primary  or 
secondary.  W  h  e  n 
the  infection  is  slight 
the  results  may  es- 
cape notice  for  weeks 
or  even  months,  the 
patients  appearing 
to  suffer  only  from 
sub-acute  or  chronic 
mammitis,  while  at 
the  same  time  the 
milk  preserves  its 
ordinary  appearance. 
In  time,  however, 
the  mammitis  be- 
comes aggravated,  the  infected  regions  are  enlarged,  and  the  secretion 
becomes  grumous,  serous,  curdled,  and  of  a  yellowish  colour,  after- 
wards ceasing  altogether.  In  some  cases  one  quarter  only  is  attacked, 
though  total  mammitis  is  more  common. 

These  forms  of  tuberculous  mammitis  tend  towards  hypertrophy, 
local  hardening,  and  the  formation  of  deeply-seated  cavities  contain- 
ing pus,  the  gland  itself  sometimes  acquiring  enormous  dimensions. 
The  retro-mammary  lymphatic  glands  are  invaded  even  before  the 
gland  itself  is  seriously  attacked.  For  a  longer  or  shorter  time  the 
udder  may  externally  appear  healthy,  although  on  manual  examina- 
tion these  lymphatic  glands  are  found  to  be  indurated  and  bosselated. 


Fig.  279. — Hypertrophic  tuberculous  mammitis. 


TUBERCULOSIS    OF    BONES    AND   ARTICULATIONS. 

Tuberculosis   of    the    bones   is  seen   only   in   young    animals,    and 
3hiefly  affects  the  vertebral  column  and  the  bones  of  the  head.     The 


702 


Infectious  diseases. 


limb  bones  are  attacked  as   a   rule   only  in   the   vicinity   of   diseased 
articulations. 

The  vertebral  lesions  corresponding  to  those  in  Pott's  disease  in 
human  beings  are  very  difficult  to  discover  before  they  produce  com- 
plications, such  as  depression  of  the  spine,  compression  of  the  spinal 
cord,  paralysis,  etc. 

Lesions  of  the  bones  of  the  head  or  of  the  limbs  are  charac- 
terised by  local  deformity,  destruction  of  osseus  tissue,  invasion  of 
surrounding  tissues,  and  by  local  symptoms  peculiar  to  tumours 
originating  in  the  periosteum. 

Tuberculosis  of  joints  produces  special  symptoms  resembling  those 
seen   in  the  "  white   swellings "  of  man,   that  is,    diffuse,  cedematous, 

warm  and  moderately 
painful  swelling  of 
adjacent  parts,  ac- 
companied by  lame- 
ness of  varying  in- 
tensity. According  to 
Guillebeau  and  Hess, 
many  conditions  de- 
scribed as  strain  or 
rheumatic  arthritis 
are  really  tuberculous 
in  character.  They 
may  remain  station- 
ary for  a  long  time, 
or  even  recede  under 
treatment.  As  a  rule, 
however,  these  forms 
of  tuberculous  arthritis  assume  the  fungoid  type  and  prove  incurable. 
They  are  clinically  distinguished  from  ordinary  arthritis  by  the 
enormous  swelling,  which  involves  the  extremities  and  a  portion  of 
the  shafts  of  the  bones.  The  adjacent  muscles  are  chronically  con- 
tracted, and  the  diseased  joint  is  held  semi-flexed.  In  course  of  time, 
if  the  patients  are  kept  alive,  abscess  formation  may  occur,  but  this 
is  seldom  seen  in  practice,  because  the  animals  are  slaughtered. 


Fict.  280. — Perforating  tuberculosis  of  the  right 
frontal  region. 


TUBERCULOSIS    OF    THE    BRAIN. 

Tuberculosis  of  the  nervous  centres,  localised  either  in  the  meninges 
or  the  brain  proper,  may  attack  both  young  and  old  animals,  not  as  a 
primary  condition,  but  as  a  sequel  to  visceral  disease,  which,  however, 
may  have  produced  no  outward  indications,  a  fact  that  renders  the 
diagnosis  extremely  difficult. 


TITBERCULOSLS    OF    THE    SKlN.  70S 

When  localised  in  the  meninges,  the  disease  produces  the  symp- 
toms of  ordinary  meningitis,  general  weakness,  vacillating,  stagger- 
ing or  irregular  gait,  disturbed  vision,  variation  in  the  size  of  the 
pupils,  difficulty  in  swallowing,  muscular  twitching,  cramp  of  the 
muscles  along  the  upper  margin  of  the  neck,  etc. 

Tuberculosis  of  the  brain  proper  seems  more  commonly  to  affect 
the  anterior  convolutions  and  the  depths  of  the  frontal  and  temporal 
lobes.  It  produces  some  of  the  symptoms  of  meningitis  or  symptoms 
suggestive  of  the  existence  of  ccenurosis,  as,  for  instance,  walking 
in  circles,  lameness  of  central  origin,  without  appreciable  lesions  of 
the  limbs,  prolonged  kneeling,  disturbed  vision,  generalised  attacks 
of   epilepsy   or   of   Jackson's  epilepsy,  spasm  of   the  pharynx,  general 


Fig.  281. — Tuberculosis  of  the  brain.     1,  2  and  3,  Tuberculous  centres. 

signs    of   compression    of     the     brain    or    cerebral     dropsy,    dulness, 
coma,  etc. 

In  the  absence  of  pulmonary  lesions  it  is  extremely  difficult  to 
arrive  at  an  exact  diagnosis  except  after  injection  of  tuberculin,  for 
the  above  symptoms  very  closely  resemble  those  of  ccenurosis,  brain 
tumours,  and  even  tumours  in  the  frontal  sinuses. 

TUBEKCULOSIS    OF    THE    SKIN. 

Cutaneous  tuberculosis  is  one  of  the  rarest  forms  of  the  disease. 
It  is  distinguished  by  the  formation  beneath  the  skin  of  little  har- 
dened swellings  varying  in  size  between  a  hazel-nut  and  a  walnut, 
and  containing  caseous  or  calcareous  material.  These  swellings  have 
no  connection  with  the  superficial  lymphatic  glands.  They  may  be 
found  grouped  together  within  certain  areas,  or  distributed  irregularly 
over  the  whole  bod}^  particularly  towards  the  base  of  the  tail. 

The  condition  may  be  mistaken  for  generalised  sarcomatosis,  from 


704  INFECTIOUS   DISEASES. 

which,  however,   it  is  readily  distinguished  hy  microscopic    examina- 
tion of  the  contents  of  the  swellings. 

ACUTE  TUBERCULOSIS TUBERCULOUS  SEPTICEMIA. 

However  rapidly  the  above-described  forms  of  tuberculosis  may 
develop,  the  disease  as  a  whole  is  always  of  long  duration,  and  con- 
tinues for  months,  or  even  for  years.  The  development  of  these 
chronic  forms  may,  however,  be  interrupted  by  various  influences 
which  cause  it  to  assume  an  acute  character,  either  for  a  time  or 
continuously.      Each    intermittent   attack  aggravates  the   condition   of 


Fig.  282. — General  appearance  of  a  case  of  cutaneous  tuberculosis. 

the  patient,  but  gradually  subsides,  with  or  without  treatment.  Con- 
tinued attacks,  however,  rapidly  lead  to  death;  they  may  be  seen  in 
animals  previously  unsuspected  of  any  grave  disorder. 

The  dominant  symptom  is  continuous  fever,  accompanied  by  signs 
of  disturbance  of  any  or  all  of  the  chief  bodily  functions. 

The  temperature  rises  to  102°  Fahr.  (39°  C),  or  even  to  10-1°  or 
105°  Fahr.  (40°  or  41°  C),  with  morning  and  evening  remissions  of 
some  hours.  The  respiration  is  accelerated.  On  auscultation  it  is 
often  difficult  to  discover  signs  of  chronic  tuberculosis.  The  lung  is 
the  site  of  repeated  congestive  changes,  resembling  those  of  broncho- 
pneumonia or  contagious  pleuro-pneumonia.  The  pleura  and  walls  of 
the  chest  become  extremely  sensitive,  as  in  the  last-named  disease, 
and  the  abdomen  may  exhibit  signs  of  peritonism,  as  at  the  begin- 
ning  of   acute  peritonitis.      The   pulse   rises  to  80,  90,  100,    or  even 


TUBERCULOSIS.  705 

120  beats  per  minute,  and  the  urine  contains  albumen  in  notable 
quantities.  This  condition  continues  for  weeks  without  apparent  di- 
minution, the  patients  refuse  food,  lose  flesh  with  startling  rapidity, 
and  finally  die  of  exbaustion. 

It  would  be  impossible  from  these  peculiarities  alone  to  identify 
the  nature  of  the  disease  which  causes  such  progressive  organic 
wasting,  as  the  continued  presence  of  fever  prevents  the  use  of 
tuberculin,  but  fortunately  the  preliminary  changes  in  the  lungs, 
lymphatic  glands,  genital  tract,  etc.,  are  sufficient  in  most  cases  for 
the  purposes  of  diagnosis. 

Sheep,  Goats,  and  Pigs. — In  the  other  domestic  animals  tubercu- 
losis is  only  of  secondary  importance  to  the  practitioner. 

It  has  been  seen  in  the  sheep  and  goat,  but  almost  exclusively  as 
the  result  of  experiment.  It  must  be  understood,  however,  that  pro- 
longed co-habitation  with  diseased  oxen  or  lengthened  sojourn  in  con- 
taminated places  may  easily  produce  tuberculosis  in  the  goat,  though 
the  sheep  continues  to  resist  for  a  somewhat  longer  period. 

Clinically  such  tuberculosis  presents  little  interest  on  account  of 
its  rarity. 

The  same  remark  applies  to  pigs  ;  nevertheless,  an  entire  herd 
may  become  infected,  and  it  may  be  necessary,  after  making  a  pre- 
limiPiary  post-mortem,  to  examine  the  other  patients.  All  forms  of 
the  disease  occur  in  pigs,  the  lung  being  most  frequently  affected,  but 
tuberculosis  also  attacks  the  intestine,  udder,  lymphatic  glands,  joints, 
etc.  The  pig,  in  fact,  is  extremely  susceptible  to  this  disease,  whilst 
the  sheep  is  only  subject  to  it  in  a  comparatively  trifling  degree. 

Diagnosis.  The  clinical  manifestations  of  tuberculosis  are  so 
numerous  and  so  various  that  it  is  often  an  extremely  hard  task  to 
form  a  diagnosis.  Without  doubt  detection  is  relatively  easy  in  well- 
marked  forms,  such  as  tuberculosis  of  the  lungs,  lymphatic  glands 
and  genital  apparatus,  but  even  in  such  cases  the  symptoms  must 
1)6  reasonably  well-marked. 

At  first,  unless  the  lesions  produce  externally  visible  signs,  diag- 
nosis is  impossible,  and  in  the  case  of  hidden  forms,  such  as  tuber- 
culosis of  the  serous  membranes,  mediastinum,  intestine,  testicle,  etc., 
all  that  can  be  done  is  to  take  into  account  the  probabilities. 

Clinical  diagnosis  is  therefore  possible,  but  only  in  exceptional 
cases  can  it  be  absolutely  relied  upon.  Fortunatel}^  methods  of  in- 
vestigation increase  and  become  more  exact  every  day,  so  tbat  the 
points  which  clinical  examination  is  incapable  of  deciding  are  often 
cleared  up  in  the  laboratory.  Bacteriological  examination  of  morbid 
products,  such  as  the  nasal  discharge,  the  products  of  suppuration, 
the  milk  or  the  diseased  tissues,  is  a  valuable  means  in  many  cases 

D.C.  7'  Z 


•06 


INFECTIOUS   DISEASES. 


of  determining  the  presence  of  the  organism  which  causes  the  dis- 
turbance. In  all  cases,  in  fact,  the  tubercle  bacillus  should  be  sought 
for  in  order  to  confirm  the  diagnosis. 

If   this  method  cannot   be   employed,   as   for  example  in  tubercu- 
losis of  the  liver,  brain,  etc.,  and  the  diagnosis  is  uncertain,  the  use 

of  tuberculin  constitutes 
the  surest  and  easiest 
method  of  coming  to  a 
conclusion.  Nocard's  re- 
searches have  shown'  the 
precautions  to  be  ob- 
served. A  minimum  feb- 
rile re-action  of  2"  Fahr. 
(1-5°  C.)  is,  however, 
necessary  before  the 
existence  of  the  disease 
can  be  affirmed. 

Lastly,  there  remains 
a  less  rapid  method, 
which  aims  at  trans- 
mitting the  disease  to 
specially  susceptible 
animals  by  inoculating 
with  suspected  materials, 
such  as  the  nasal  dis- 
charge, pus,  milk  or 
pulp  of  internal  organs. 
This  method  is  most 
valuable  when  bacterio- 
logical examination  has 
failed  and  tuberculin  has 
produced  only  doubtful 
results.  The  guinea-pig 
is  the  subject  usually 
chosen,  but  some  weeks, 
or  even  months,  may  elapse  before  definite  results  are  obtained. 

In  those  forms  where  ordinary  methods  of  investigation  prove 
sufficient  it  is  well  to  bear  in  mind  the  symptoms  which  difterentiate 
this  disease  from  others  closely  resembling  it. 

Pulmonary  tuberculosis,  for  example,  should  always  be  suspected 
whenever  there  exists  frequent  coughing,  nasal  discharge  and  poor 
bodily-  condition  ;  if  in  addition  to  this  respiration  is  found  on  auscul- 
tation   to    be    rough,    inspiration    hiterrupted    or    rasping,    expiration 


Fig.  283. — Tuberculosis  of  the  posterior  mediastinal 
lymphatic  glands  in  a  sheep  which  had  been 
kept  for  two  years  in  company  with  some  tuber- 
culous cows.  PG,  Left  lung;  PD,  right  lung; 
T,  trachea ;  La,  anterior  lobes ;  L,  middle  cardiac 
lobes  ;  L^j,  posterior  lobes ;  G;«,  tuberculous  and 
enlarged  posterior  mediastinal  lymphatic  glands. 


TUBEECULOSIS.  707 

prolonged  or  blowing  and  the  vesicular  murmur  non-existent,  suspicion 
becomes  almost  a  certainty.  The  diagnosis  is  even  more  assured 
if  the  respiration  is  of  a  blowing  character  at  certain  points,  ac- 
companied by  snoring  and-  sibilant  rales  and  gurgling  or  cavernous 
souffles. 

The  distinction  between  pulmonary  tuberculosis  and  chronic  bron- 
chitis or  simple  pulmonary  emphysema  is  based  on  the  increased 
resonance  revealed  by  percussion  in  the  latter  case  ;  the  different 
character  of  expiration ;  the  existence  of  a  double  breathing  move- 
ment ;  the  external  appearance  of  the  animal ;  the  absence  of  bacilli 
from  the  nasal  discharge,  and  the  failure  to  react  to  tuberculin. 

The  condition  cannot  be  mistaken  for  verminous  broncho-pneu- 
monia if  the  information  furnished  by  auscultation  and  the  results  of 
microscopical  examination  of  the  discharge  are  taken  into  account, 
the  eggs  or  embryos  of  strongyles  being  extremely  easy  to  detect. 

Tuberculosis  of  the  pleura  may  be  mistaken  for  peri-pneumonia  if 
the  observer  trusts  to  percussion  alone,  but  the  auscultation  sounds 
are  then  different,  and  an  injection  of  tuberculin  will  remove  any 
doubt. 

Tuberculosis  of  the  peritoneum  is  often  suggested  by  the  indica- 
tions afforded  by  careful  palpation  (thickening  of  the  walls  of  the 
abdomen,  rigidity  and  sensitiveness),  and  is  distinguished  from  ordi- 
nary acute  peritonitis  by  the  difference  in  the  appearance  of  the 
animals  and  the  absence  of  much  fluid.  Chronic  exudative  perito- 
nitis and  ascites  also  exhibit  sufficiently  well-marked  characteristics 
to  enable  them  to  be  differentiated  from  tuberculosis  of  the  peri- 
toneum, but  this  is  certainly  not  true  of  adhesive  peritonitis,  and  in 
cases  of  the  latter  kind  tuberculin  is  the  only  means  of  confirming 
the  diagnosis. 

External  tuberculosis  of  the  retro-pharyngeal  and  cervical  lym- 
phatic glands  resembles,  at  a  first  glance,  simple  inflammation  of 
lymphatic  glands,  but  in  the  last-mentioned  disease  the  lesions  are 
symmetrical  and  the  glands'  still  retain  a  certain  amount  of  elasti- 
city, whilst  in  tuberculosis  they  are  bosselated,  hard,  and  sometimes 
fluctuating. 

Tuberculosis  of  the  mediastinum  is  suggested  by  difficulty  in  swal- 
lowing, especially  if  tympanites  follows  soon  after  eating,  eructation 
is  absent,  and  rumination  is  arrested. 

A  careful  study  of  the  development  of  the  ulcerations  will  also  in 
most  instances  make  clear  the  difference  between  tuberculous  stoma- 
titis and  simple  stomatitis  or  stomatitis  due  to  actinomycosis.  Intes- 
tinal tuberculosis  and  tuberculous  enteritis  are  sufficiently  charac- 
terised by  persistent  intractable  diarrhoea  accompanied  by  tympanites, 

z  z  2 


708  INFECTIOUS   DISEASES. 

b}'  the  foetid  character  of  the  fteces,  and  by  moderate  but  contmued 
fever.  Chronic  diarrhcea,  which  alone  presents  some  analog}^  with 
this  condition,  is  never  accompanied  by  permanent  tympanites. 

Tuberculosis  of  the  genital  organs  in  male  animals  is  always 
liable  to  be  mistaken  for  simple  orchitis  and  the  development  of 
tumours  in  the  testicle ;  an  injection  of  tuberculin  will,  however,  in- 
dicate the  nature  of  the  lesion. 

When  the  symptoms  of  genital  disease  or  chronic  mammitis  in 
female  animals  suggest  that  the  disease  is  of  a  specific  character, 
the  diagnosis  can  frequently  be  confirmed  by  a  microscopical  exami- 
nation of  the  pus  or  milk. 

Finally,  should  the  practitioner  hesitate  as  to  the  nature  of  the 
lesions  which  are  the  cause  of  arthritis,  deformity  of  bones,  cere- 
bral symptoms,  etc.,  tuberculin  again  will  in  most  cases  settle  the 
question. 

The  prognosis  in  cases  of  tuberculosis  is  extremely  unfavourable, 
whatever  the  form  of  the  disease  or  its  manifestations.  Clinically 
the  disease  should  be  regarded  as  incurable  in  the  strict  sense  of 
the  word,  however  limited  may  be  the  lesions.  The  afiected  animals 
are  not  all  doomed  to  immediate  death  :  some  may  be  kept  alive,  and 
may  even  serve  an  economic  purpose  without  necessarily  endangering 
others  ;  it  is  sometimes  possible  to  fatten  them,  though  the  risks 
probably  far  outweigh  the  advantages,  but  one  can  never  rely  on 
recovery  in  any  particular  case. 

The  gravity  of  this  disease  is  the  greater  inasmuch  as  it  assumes 
so  many  forms,  any  one  of  which  may  result  in  the  infection  of 
other  animals. 

All  those  forms  of  the  disease,  such  as  tuberculosis  of  the  respira- 
tory, digestive  and  genital  tracts,  in  which  virulent  material  con- 
taining bacilli  is  discharged  realise  these  conditions.  The  patient 
becomes  a  source  of  infection  to  others  of  its  kind,  a  fact  which 
more  than  anything  else  renders  the  disease  so  dangerous  to  the 
farmer  and  breeder. 

Only  in  cases  where  the  lesions  are  closed  (as  in  tuberculosis  of 
the  lymphatic  glands,  serous  membranes,  joints,  etc.)  can  the  sufferers 
be  regarded  as  innocuous,  and — as  these  lesions  are  exceptional  or 
at  least,  as  animals  suffering  from  them  are  very  frequently  afflicted 
with  open  lesions  from  which  bacilli  are  continually  being  dis- 
charged— every  tuberculous  animal  must  be  regarded  from  a  clinical 
standpoint  as  a  constant  danger  to  its  neighbours. 

This,  however,  must  not  be  understood  to  mean  that  there  are 
not  different  degrees  of  danger.  It  is  quite  certain  that  a  patient 
with  pulmonary  caverns  which  are  constantly  throwing  off"  enormous 


TUBERCULOSIS.  709 

quantities  of  material  full  of  bacilli  is  much  more  dangerous  than 
another  suffering  only  from  slight  bronchial  or  tracheal  lesions, 
though  the  danger  in  the  latter  case  is  none  the  less  always  present. 

Treatment.  There  is  no  really  curative  treatment  of  tuber- 
culosis. 

It  must  not  be  thought,  however,  that  we  are  completely  helpless 
and  that  the  present  condition  of  affairs  must  be  allowed  to  con- 
tinue indefinitely.  Nocard  and  Leclainche  have  minutely  laid  down 
the  lines  to  be  followed  as  regards  prophylaxis,  though  unfortu- 
nately the  measures  recommer.ded  cannot  always  be  carried  out. 

Tuberculin  having  been  proved  an  exact  means  of  detecting 
tuberculous  lesions  in  animals  even  where  none  were  suspected,  it 
is  desirable,  firstly,  to  test  all  the  animals  in  a  given  establish- 
ment with  tuberculin ;  and,  secondly,  to  separate  into  classes  (1)  all 
animals  which  have  reacted,  and   (2)  those  which  have  resisted. 

The  stables,  etc.,  should  then  be  completely  disinfected  by 
sweeping,  washing  first  Nvith  hot  water,  then  with  strong  anti- 
septic solutions,  brushing  over  the  walls  with  quick-lime  solution  and 
fumigating  with  sulphurous  acid  or  formic  aldehyde.  Tiie  healthy 
animals  should  then  be  placed  in  one  shed  and  the  diseased  animals 
hx  another.  In  order  to  render  this  system  of  isolation  really 
efiicacious  the  isolated  animals  and  the  healthy  animals  should  have 
nothing  in  common,  and  the  persons  tending  the  two  classes  of 
animals,  the  buckets  and  other  utensils,  the  watering  places,  etc., 
should  be  kept  rigorously  apart. 

The  animals  known  to  be  tuberculous  should  as  rapidly  as 
possible  be  prepared  for  slaughter,  and  if  pregnant  cows  are  included 
in  the  number  the  calves "  should  be  removed  to  the  healthy  stable 
immediately  after  birth  and  brought  up  either  on  boiled  milk  or  by 
a  healthy  mother,  experience  having  shown  that  congenital  tuber- 
culosis is  of  rare  occurrence. 

After  the  tuberculous  animals  have  left  the  shed,  this  should 
again  be  thoroughly  disinfected,  in  order  to  make  it  fit  for  the 
reception  of  healthy  subjects. 

Unfortunately  such  precautions  can  only  be  observed  in  model 
establishments.  They  necessitate  expenses  and  immediate  sacrifices 
of  a  very  serious  character,  and  breeders  too  often  view  only  the 
sacrifice  without  regard  to  the  after  benefits.  For  this  reason  the 
above  system  has  only  been  practised  in  certain  of  the  best  known 
and  best  managed  farms. 

To  ensure  the  full  benefit  of  these  precautions,  and  to  prevent 
a  fresh  introduction  of  tuberculosis  into  the  herd,  every  new  animal 
introduced    should    be    subjected    to   the    tuberculin    test.     Unless    this 


710  INFECTIOUS    DISEASES. 

precaution  is  taken,  there  is  always  a  risk  of  introducing  a  tuber- 
culous subject,  thus  nullifying  all  the  precautions  previously  taken. 

The  problem  is  therefore  still  very  complex,  and  the  system  can 
only  give  good  results  when  rigorously  observed  and  followed  out. 

As,  however,  in  spite  of  all  precautions,  animals  regarded  as 
healthy  are  always,  under  normal  conditions  of  existence,  more  or 
less  exposed  to  accidental  infection,  it  is  desirable  to  subject  the 
entire  herd  to  the  tuberculin  test  annuall3\  This  would  cause  the 
immediate  detection  of  any  animals  with  latent  infection,  so  that 
they  could  be  removed  from  the  herd. 

These  wise  precautions  might,  if  understood  and  observed, 
eliminate  the  disease  from  the  country,  but  they  depend  on  indi- 
vidual initiative,  and  have  not  as  yet  been  grasped  by  the  mass  of 
small  breeders,  farmers,  etc.  This  class  only  see  the  difficulties  in 
the  way  of  realising  the  idea,  without  appreciating  the  constant 
benefit  which  they  would  derive  from  it. 

SWINE    FEVER— VERRUCOUS    ENDOCARDITIS    AND    PNEUMONIA 
OF    THE    PIG. 

Although  it  is  not  contemplated  in  this  work  to  deal  with  those 
disorders  which,  on  account  of  their  highly  contagious  or  infectious 
character,  can  only  be  dealt  with  by  legislative  action  and  by  pro- 
cesses of  "  stamping-out,"  it  may  be  permissible  to  make  certain 
exceptions.  While  we  have  made  no  reference  to  contagious  pleuro- 
pneumonia of  cattle,  foot-and-mouth  disease,  rinderpest,  anthrax  and 
black-quarter  we  have  devoted  some  space  to  Texas  fever  and  tuber- 
culosis, and  give  herewith  a  summary  of  the  present  state  of  know- 
ledge regarding  swine  fever  or  hog  cholera  and  a  hnemorrhagic  sep- 
ticaemia of  cattle  known  under  various  names  in  different  countries 
and  of  very  wide  distribution. 

SWINE     FEVER.* 

Swine  fever  may  assume  two  distinct  forms,  viz.,  the  acute  and 
fatal  and  the  non -acute  or  slowly  progressive. 

Symptoms.  In  the  acute  form  all  those  sjaiiptoms  which  are  indi- 
cative of  a  severe  febrile  affection  are  present.  The  animals  are 
disinclined  to  feed ;  they  present  evidence  of  great  prostration  and  lie 
about  their  dwellings  in  a  listless  manner  sheltering  themselves  from 
cold ;  their  skins  are  hot,  their  eyes  partially  closed,  and  they  are 
obviously  suftering  from  some  severe  constitutional  disturbance.    Within 

*  Eeport  of  the  Depavtiiiental  Committee  re  Swine  Fever.  (Annual  Report  of 
Board  of  Agriculture,  1896.) 


SWINE    FEVER.  711 

a  very  few  hours  after  these  premonitory  symptoms  have  set  in  the 
pigs  become  rapidly  worse  ;  they  may  or  may  not  have  a  deep-red 
bhish  on  the  skin,  which  is  more  particiUarly  noticeable  on  those 
parts  of  the  body  where  there  is  an  absence  of  hair,  such  as  the 
inside  of  the  thighs,  the  point  of  the  axilla,  and  over  the  abdomen. 
Choleraic  evacuations,  having  a  most  offensive  odour,  succeeding 
upon  constipation,  follow  later  on,  and  the  animals  die  perhaps  as 
early  as  the  third  or  fourth  day  after  the  symptoms  have  first  been 
observed. 

In  some  instances  the  disease  proceeds  with  great  rapidity 
through  a  herd,  the  symptoms  being  of  a  most  aggravated  and  pro- 
nounced character,  and  the  outbreak  attended  with  great  fatality. 

Generally  speaking,  the  above  description  depicts  the  symptoms 
of  swine  fever  in  the  acute  form,  more  especially  when  it  breaks 
out  in  a  herd  of  young  pigs. 

In  the  non-acute  form  the  disease  progresses  slowly,  the  clinical 
evidence  is  extremely  obscure,  the  reddening  of  the  skin,  formerly 
regarded  as  being  invariably  present  in  swine  fever,  is  absent,  and 
beyond  the  fact  that  the  animal  is  unthrifty,  develops  slowly,  and 
perhaps  has  a  constantly  relaxed  condition  of  the  bowels,  it  may  be 
asserted  that  there  are  no  symptoms  which  could  be  regarded  as 
absolutely  indicative  of  swine  fever,  and  nothing  short  of  a  post- 
mortem examination  will  enable  even  an  expert  to  satisfy  himself 
that  the  animal  was  affected  with  the  disease. 

As  a  general  rule  swine  fever  assumes  this  non-acute  and  slowly 
progressive  form  in  pigs  which  have  arrived  at  an  age  when  their 
powers  of  resistance  to  disease  are  materially  increased,  i.e.,  in 
animals  of  eight  or  more  months  old ;  on  post-mortem  examination 
they  are  found  to  have  been  extensively  diseased,  more  particularly 
in  the  large  intestine,  a  portion  of  the  digestive  apparatus  which 
does  not  appear  to  perform  any  very  important  function  in  con- 
nection with  the  nutrition  of  the  animal,  and  so.  long  as  the  stomach 
and  small  intestines  remain  healthy,  pigs  with  a  considerable  amount 
of  disease  in  the  large  intestine  may  still  keep  up  their  condition 
for  a  considerable  time. 

Etiology.  As  regards  the  etiology  of  the  form  of  swine  fever 
prevalent  in  England  no  question  now  exists.  It  has  been  proved  to 
demonstration  by  the  bacteriological  inquiry  conducted  by  Professor 
McFadyean  that  it  is  due  to  a  special  pathogenic  organism,  a  bacillus, 
which,  "after  cultivation  in  artificial  media,  will  produce  in  the  healthy 
pig  fed  with  the  pure  cultures  the  typical  ulcerations  which  are 
found  in  the  intestines  of  pigs  affected  with  swine  fever  contracted 
in    the   ordinary  way. 


712  INFECTIOUS    DISEASES. 

The  observations  made  by  the  veterinary  officers  of  the  Board 
of  Agriculture  caused  them  to  doubt  whether  there  was  any  disease 
of  the  lungs  of  pigs  which,  in  the  absence  of  lesions  in  the  intes- 
tinal tract,  could  be  accepted  as  evidence  of  swine  fever. 

The  baciUus  which  produced  swine  fever  when  introduced  in  the 
healthy  pig  did  not  induce  any  special  disease  of  the  lungs. 

Pathology  and  morbid  anatomy.  Swine  fever,  like  typhoid  fever 
in  man,  is  essentially  a  disease  of  the  digestive  system,  its  chief 
characteristic  being  certain  morbid  changes  of  a  well-marked  nature 
which  are  found  upon  the  surface  of  the  mucous  membrane  in  some 
part  of  the  alimentary  canal. 

The  changes  referred  to  consist  of  what  have  been  commonly  de- 
scribed as  the  formation  of  a  series  of  ulcers,  single  or  confluent,  dis- 
tributed upon  some  part  of  the  intestinal  tract,  varying  in  size  and 
shape,  of  a  yellowish-grey  to  black  colour,  and  assuming  as  a  rule 
a  circular  form.  In  some  instajices  the  lesions  consist  of  diphtheritic 
exudations  with  necrosis  of  the  lining  membrane  of  the  bowels. 

These  ulcers  or  necrotic  patches  may  be  found  upon  the  tongue, 
tonsils,  epiglottis,  stomach,  and  small  intestines,  but  they  are  more 
constant  in  the  large  intestines,  especially  the  caecum  and  colon.  The 
lesions  may  involve  the  whole  thickness  of  the  mucous  meuibrane, 
but  seldom  penetrate  the  other  coats  of  the  intestine  ;  in  fact,  perfora- 
tion of  the  peritoneal  covering  of  the  bowel  is  very  rare  in  even 
prolonged  cases  of  swine  fever. 

In  cases  where  swine  fever  assumes  the  more  acute  form  and 
death  supervenes  rapidly,  it  is  usual  to  find  that  the  small  intestines 
are  largely  involved. 

In  the  non-acute  or  slowly  progressing  form  the  lesions  are  more 
abundant  in  the  large  intestines,  and  in  some  instances  the  walls  of 
the  intestines  become  so  thick  as  a  result  of  infiltration  into  their 
structure  and  the  excessively  thick  deposits  upon  the  lining  mem- 
brane, that  it  becomes  a  matter  of  surprise  that  the  passage  of  the 
ingesta  has  been  possible  and  that  the  animal  has  lived  so  long. 

Next  to  the  intestinal  lesions  the  congested  condition  of  the  lym- 
phatic glands,  especially  those  of  the  mesentery,  may  be  considered 
as  most  ])rominent  among  the  pathological  changes  which  occur  in 
swine  fever.  Occasionally  centres  of  necrosis  are  observed  in  the 
liver,  and  some  writers  refer  to  changes  in  or  upon  the  spleen  and 
kidneys. 

The  only  lesions  which  can  be  characterised  as  absolutely  typical 
of  swine  fever  are  those  present  in  the  bowels,  the  absence  of  which 
will  justify  any  observer  in  declining  to  accept  the  case  as  one 
of    swine   fever  without    some    further   evidence  or   inquiry.     It  must. 


VERRUCOUS  ENDOCARDITIS  UK  THE  I'KJ.  713 

however,  be  distinctly  understood  that  in  the  case  of  very  young  pigs 
which  have  died  shortly  after  infection,  tliere  is  often  an  entire 
absence  of  the  lesions  described,  the  onl}'  changes  present  being 
inflammation  of  the  stomach  or  some  part  of  the  intestines. 

Further,  there  are  instances  where  older  pigs  have  been  slaughtered 
in  the  early  stage  of  the  disease  in  which  no  definite  lesions  have  been 
found,  and  in  such  cases  inquiry  into  the  condition  of  the  rest  of  the 
herd  becomes  necessary. 

One  most  important  feature  in  connection  with  the  morbid  anatomy 
of  swine  fever  is  the  disposition  which  many  animals  have  to  recover 
from  the  disease  ;  evidence  of  the  reparatory  process  having  often  been 
detected  in  the  intestines  after  they  had  been  carefully  washed. 

Dr.  Klein  also  maintained  that  many  pigs  took  the  disease  in  the 
mild  form,  and  recovered  without  presenting  any  of  the  marked 
symptoms  of  swine  fever. 

It  was  found  that,  whether  infected  in  the  ordinary  way  or  by 
direct  inoculation,  in  some  pigs  killed  only  a  few  days  after  being  in- 
fected the  ulcers  were  occasionally  seen  gradually  detaching  from  the 
surface  of  the  intestines,  and  cicatrisation  had  already  commenced. 


VERRUCOUS    ENDOCARDITIS    OF    THE    PIG, 

In  the  report  of  the  Board  of  Agriculture  for  1894  reference  was 
made  to  the  numerous  instances  in  which  the  heart  of  the.  pig  had 
l)een  found  affected  with  verrucous  endocarditis. 

This  form  of  disease  of  the  heart  was  known  to  veterinarians  in 
Great  Britain  as  far  back  as  the  year  1847.  For  reasons  given  in 
that  report  it  became  obvious  that  this  diseased  condition  of  the 
valves  of  the  heart  was  not  produced  by  swine  fever.  The  question 
arose  whether  in  addition  to  sw'ine  fever  another  disease  existed, 
known  on  the  Continent  under  the  name  of  swine  erysipelas.  The 
importance  of  this  question  will  be  appreciated  when  it  is  explained 
that  on  the  Continent  swine  erysipelas  is  classed  among  the  con- 
tagious diseases  of  the  pig. 

The  clinical  evidence  of  the  disease  called  swine  erysipelas  on  the 
Continent  appears  to  be  more  or  less  discoloration  of  the  skin,  similar 
to  that  which  is  frequently  observed  in  swine  fever,  together  with  the 
occasional  presence  within  the  warty  growths  upon  the  valves  of  the 
heart  of  a  bacillus  which  is  regarded  by  Continental  authorities  as 
the  cause  of  the  disease. 

Early  in  the  inquiry  it  was  ascertained  that  a  bacillus  identical 
with  that  found  in  swine  erysipelas  was  also  present  in  the  diseased 
portion  of  the  valves  of  the  heart  of  the  pigs  in  this  country. 


714  INFECTIOUS    DISEASES. 

But  the  inquiries  made  did  not  corroborate  or  favour  the  suggestion 
that  the  disease  which  produced  these  morbid  growths  was  in  any  way 
infectious  or  contagious.  Such  inquiries  as  could  be  made  led  to  the 
opposite  conclusion,  since  in  every  instance  where  the  cases  could  be 
followed  up  it  was  ascertained  that  the  deaths  had  been  quite  sudden, 
were  limited  to  a  single  animal,  and  that  those  in  contact  remained 
in  perfect  health. 

At  this  stage  the  all -important  point  to  determine  was  whether 
the  disease  which  existed  in  this  country,  "verrucous  endocarditis," 
was  communicable  from  pig  to  pig,  and  with  this  object  numerous 
experiments  have  been  conducted  to  discover  whether  the  bacilli  found 
within  the  hearts  of  diseased  pigs  were  pathogenic  to  healthy  swine. 

A  large  number  of  healthy  pigs  have  been  fed  or  inoculated  with 
the  blood,  the  diseased  portions  taken  from  the  valves  of  the  heart, 
and  with  artificial  cultures  of  the  bacilli  obtained  from  the  heart, 
but  in  no  instance  has  the  attempt  to  produce  this  disease  been 
successful. 

PNEUMONIA    OF    THE    PIG. 

The  occasional  association  of  pneumonia  with  or  without  pleurisy 
in  cases  of  swine  fever  has  led  many  veterinarians  in  England  to 
regard  lung  complications  as  one  of  the  lesions  produced  by  that 
disease. 

In  the  Board  of  Agriculture's  report  for  the  year  1894  a  description 
was  given  of  the  various  diseases  in  the  lungs  of  swine  which  had 
come  under  notice,  and  it  was  therein  stated  that  the  Board  had 
been  unable  to  discover  any  special  lesion  of  the  lung  which  would 
warrant  them  in  stating  that  it  was  indicative  of  swine  fever  or  due 
to  contagion. 

It  is  an  indisputable  fact  that  pigs  are  extremely  liable  to  pneumonia 
and  pleurisy.  But  as  the  clinical  appearances  present  in  the  lungs 
examined  in  no  wise  differed  from  those  which  take  place  in  the  lungs 
of  other  animals  which  have  been  exposed  to  cold  or  septicaemia  and 
other  causes,  the  Board's  officers  have  never  accepted  these  lesions  as 
being  specific. 

It  is  well  known  that  both  in  Germany  and  the  United  States  out- 
breaks of  pneumonia  of  a  contagious  nature  attributed  to  the  presence 
of  a  bacillus  pathogenic  to  the  pigs  of  those  countries  are  reported  to 
occur.  Indeed,  contagious  pneumonia  of  swine  under  the  names  of 
schweinesuche  in  Germany  and  swine  plague  in  America  are  regarded 
as  one  and  the  same  disease. 

In  view  of  the  fact  that  in  a  large  number  of  cases  pneumonia, 
more  or  less  extensive,  sometimes  associated  with  pleurisy,  was  found 


PNEUMONIA    OF   THE   PIG.  715 

among  the  specimens  forwarded  to  London,  it  was  considered  desirable 
that  the  departmental  committee  should  institute  a  series  of  experi- 
ments to  decide  whether  we  had  in  this  country  a  form  of  pneumonia 
in  the  pig  which  Avas  communicable  from  one  pig  to  another. 

Accordingly  a  series  of  bacteriological  experiments  were  conducted 
by  Professor  McFadyean  with  a  view  to  isolate,  if  possible,  a  micro- 
organism which  would  be  capable  of  inducing  pneumonia  in  healthy 
pigs.  A  number  of  diseased  lungs,  some  of  which  were  taken  from 
pigs  affected  with  swine  fever,  were  examined  microscopically  by  him, 
and,  as  was  to  be  expected,  several  organisms  were  isolated,  but  they 
proved  to  be  morphologically  and  culturally  different  from  the  bacillus 
of  swine  fever.  Inoculations  were  carried  out  with  these  organisms 
not  only  subcutaneously  but  directly  into  the  lung  through  the  walls 
of  the  chest,  and  feeding  experiments  were  also  conducted.  The 
results  of  these  experiments  were  entirely  negative ;  a  certain  amount 
of  local  injury  was  caused  to  the  lungs  at  the  seat  where  they  had 
been  punctured,  but  in  no  case  was  either  pneumonia  or  swine  fever 
induced. 

The  experiments  have  therefore  demonstrated  that  the  pneumonia 
found  in  the  lungs  of  pigs  affected  with  swine  fever  is  not  due  to  the 
swine  fever  bacillus. 

The  departmental  committee  arrived  at  the  conclusion  that  the 
pneumonia  which  is  occasionally  encountered  as  an  independent 
disease  of  the  pig  or  in  association  with  swine  fever  is  not  ascribable 
to  contagion,  but  to  the  presence  of  organisms  which  are  generally 
saprophytic  in  their  mode  of  life,  and  which  only  in  particular  cir- 
cumstances (such  as  lowered  vitality  and  diminished  resistance  on  the 
part  of  the  pig)  are  able  to  multiply  in  the  air  passages  and  lung 
tissue  and  thus  induce  pneumonia  ;  and  it  appeared  to  the  departmental 
committee  that  in  this  country  pneumonia  of  the  pig  is  sporadic  and 
not  contagious  or  epizootic. 

CONCLUSIONS. 

There  is  now  no  reason  whatever  to  believe  that  there  exists  at 
the  present  time  in  Great  Britain  any  disease  of  a  contagious  nature 
affecting  pigs  other  than  swine  fever.  The  disease  of  the  heart, 
"  verrucous  endocarditis,"  and  the  pneumonia  which  are  so  frequently 
met  with  in  pigs  cannot  be  regarded  as  lesions  indicative  of  an  attack 
of  swine  fever. 

As  regards  verrucous  endocarditis  and  pneumonia,  it  may  safely 
be  said  that  they  do  not  exist  in  England  in  a  contagious  form. 

Considering  all  the  evidence,  it  may  reasonably  be  concluded  that 
the   departmental  committee   were   correct   in   their   views  when    they 


71  G  INFECTIOUS    DISEASES. 

stated  that  "  the  evidence  obtained  daring  the  ^Yhole  inquiry  justifies 
the  conclusion  at  which  they  have  arrived,  viz.,  that  there  is  no 
epizootic  of  swine  except  swine  fever  in  any  part  of  the  United 
Kingdom  which  requires  to  be  dealt  with  under  the  provisions  of 
the  Act  of    1894." 

Finally,  it  may  be  said  that  the  great  factors  in  perpetuating  swine 
fever  will  always  be  pigs  which  are  affected  with  that  disease  in  the 
less  fatal  and  unrecognisable  form.  These  animals  are  constantly 
distributing  the  germs  of  swine  fever  through  their'  highly  infective 
evacuations  wherever  they  may  be  taken  during  the  whole  period  of 
their  illness,  and  the  final  extinction  of  the  malady  must  depend  upon 
the  possibility  of  enforcing  measures  which  will  have  the  effect  of 
preventing  the  movement  of  pigs  affected  with  swine  fever  in  this 
particular  form. 

H/EMORRHAGIC    SEPTIC/EMIA    IN    CATTLE- 

In  1902  Drs.  Wilson  and  Brimhall,  of  the  State  Board  of  Health  of 
Minnesota,  U.S.A.,  described  under  the  title  of  "  hemorrhagic  septi- 
caemia of  cattle  "  a  widespread  infectious  disease  of  bovines  which  has 
the  following  general  characteristics  : — The  disease  is  distributed  the 
world  over,  but  is  apparently  most  common  in  low-lying  regions, 
and  most  general  in  wet  seasons.  The  animals  attacked  are  of  all 
ages.  The  onset  of  the  disease  is  sudden,  its  course  rapid,  and  its 
termination  usually  (90  to  98  per  cent.)  fatal.  Thirty  to  90  per  cent, 
of  all  animals  in  an  infected  herd  die.  The  clinical  symptoms  are 
refusal  of  food,  cessation  of  rumination  and  lactation,  initially  increased 
temperature  (107°  to  ]09°F. :  42°  to  43°  C),  rapid,  laboured  breathing, 
sometimes  bloody  discharge  from  nostrils,  bladder,  and  bowels,  and 
non-crepitant  swellings  in  the  throat  region,  back  of  shoulders,  or 
about  the  fetlocks.  The  most  striking  pathological  lesions  are 
hemorrhages  from  1  millimetre  to  20  centimetres  in  diameter,  through- 
out the  subcutaneous,  submucous,  subserous  and  intermuscular  con- 
nective tissue,  infiltrating  the  lymphatic  glands,  and  involving  several 
or  all  of  the  internal  organs.  The  spleen  is  neither  enlarged  nor 
darkened.  The  causative  bacteria,  which  may  be  isolated  from  the 
larger  hsemorrhagic  areas,  lymph  glands,  heart's  blood,  lung,  spleen, 
etc.,  have  the  following  distinguishing  characteristics  : 

Ovoidal  bacilli,  with  rounded  ends  of  0"5  to  0*8  microns  in  trans- 
verse diameter,  and  1*0  to  1'5  microns  in  length;  sometimes  paired  and 
sometimes  in  chains  of  three  to  six  individuals.  The  bacilli  in  the 
tissues  exhibit  polar  staining  with  an  unstained  "belt"  or  "middle 
piece."  They  are  non-capsulated,  non-spore-forming,  non-Gramstain- 
ing,  and  non-motile.      They  grow  best  aerobically  at  98-5°  F.  (37°  C), 


H.EMORRHAGIC    SEPTICEMIA    IN    CATTLE. 


717 


though  capable  of  developing  aiiaerobically  and  at  room  temperature  ; 
prefer  the  depths  rather  than  the  surfaces  of  media ;  grow  feebly,  if  at 
all,  on  potato  ;  fail  to  liquefy  gelatine  ;  produce  acid,  but  no  gas  in 
glucose  media,  neither  acid  nor  gas  in  lactose  media ;  and  develop 
varying  amounts  of  indol  and  phenol  in  peptone  solution.  The 
organisms  have  been  named  Bacillus  hovisepticiis.  The  lesions  of  the 
disease  are  reproduced  in  cattle  and  other  animals  by  inoculation  of 
pure  cultures  of  the  organism. 

It  should  be  insisted  upon  that  the  identification  of  the  disease  in  a 
locality  in  which  it  has  not  been  previously  described,  or  by  veteri- 
narians not  having  had  previous  experience  therewith,  shall  take  into 
consideration — (a)  the  essential  clinical  symjitoms ;  (b)  the  imthological 
lesions  as  observed  before  the  onset  of  decoinposition  ;  and  (c)  the  morpho- 
logical and  biological  identification  of  the  specific  bacilli. 

The  following  is  a  tabulated  list  of  the  principal  epidemics  so 
studied  and  reported  to  January  1st,  1901  : 


Tabic  showing  the  Principcd  Epidemics  of  Ha>niorrhagic  Scpticaniia 
in  Bovines  due  to  Bacillus  bovisepticus. 


Name  of  observer. 

Year. 

Locality. 

Local  or  reporter's  name  of  disease. 

Bollinger  . 

1878 

Germany 

Wild  und  Rinderseuche. 

Kitt  .... 

188') 

,, 

Rinderseuche. 

Kitt  .... 

1887 

,, 

SeptikiEmia  hiemorrhagica. 

Poels 

1886 

Holland 

Septic  pleuro-pneumonia  of  calves. 

Oreste  et  Armanni    . 

1886 

Italy 

Barbone. 

Jensen 

1889 

Jutland 

Rinderseuche. 

Plot  .... 

1889 

Egypt 

Kounnaq. 

Van  Eecke        .        { 

1890 
1895 

[          Java 

Septichsemia  hemorrhagica. 

Hubenet   . 

1895 

^^ 

,.                          ,, 

Galtier       . 

1891 

France,  imported 
from  Algiers 

Infectious  pneumo-enteritis. 

Reischig    . 

1891 

Hungary 

Maladie  des  buffles  ou  Angine 
Charbonneuse. 

Bongartz  . 

1892 

Germany 

Wild  und  Rinderseuche. 

Jakobi 

1892 

„ 

Wildseuche. 

Buch 

1892 

^j 

Hsemorrhagische  septikaemia. 

Giillebean  and  Hess  . 

1894 

'' 

Septikaemia  haemorrhagica.     Char- 
bon  Blanc. 

Fischer      . 

1895 

Dutch  Indies 

Septichaemia  haemorrhagica. 

Leclainche 

1895 

France 

Pneumo-enteritis. 

Von  Ratz  . 

1896 

Hungary 

Barbonekrankheit. 

Sanfelice,    Loi,    and 

1897 

Sardinia 

,, 

Malato 

Bosso 

1898 

Italy 

Septicaemia  haemorrhagica. 

Pease 

1898 

British  India 

Ghotwa  or  Ghotu. 

Liguieres  . 

1898 

Argentina 

Pasteurellosis  bovina.  "  Diarrhoea  " 
and  "  Enteque." 

Fenimore  . 

1898 

Teimessee 

Wild  and  cattle  disease. 

718  INFECTIOUS    DISEASES. 

It  may  not  be  out  of  place  to  give  at  this  point  a  short  list  of 
the  principal  infective  diseases  of  definitely  known  fetiology,  with 
which  hsemorrhagic  septicfemia  in  cattle  has  been,  and  may  readily 
be,  confused : 

Name  of  disease.  Diagnostic  2)oints, 

Anthrax    .......     Altered  conclition  of  blood,  enlarged  spleen, 

presence  of  B.  anthracis,  etc. 
Black-quarter Usually  localised  lesion,  crepitant  tumour, 

presence  of  B.  anthracis  symptomatici. 
Septicpneunio-enteritis  of  calves  (Galtier)     Due  to  a  spore-bearing  bacillus — "  Pneu- 

mohacillus     sej^tictis  "  —  which     grows 

rapidly  on  potato. 
Septiciemia  of  calves  ....     Due  to  typhoid-like  bacilli. 


CONCLUSIONS. 

(1.)  Eight  outbreaks  of  haemorrhagic  septicaemia  in  cattle  due  to 
B.  hovisepticus  occurred  in  Minnesota  from  August  to  December,  1900. 

(2.)  So  far  as  can  be  determined,  the  only  other  outbreak  of  this 
disease  hitherto  published  as  occurring  in  America  was  one  near 
Knoxville,  Tenn.,  in  1898.  The  foci  of  the  disease  have  also  apparently 
been  present  in  Texas  and  the  district  of  Colombia.  No  relation  can 
be  traced  between  the  disease  elsewhere  and  the  present  outbreaks, 
nor  between  any  two  of  the  present  ones. 

(3.)  Of  160  animals  in  the  eight  herds,  sixty-four  showed  symptoms 
of  the  disease,  and  all  such  died — a  mortality  of  40  per  cent,  of  all 
the  animals  in  the  herds,  and  of  100  per  cent,  of  those  showing 
symptoms. 

(4.)  The  chief  symptoms  were  loss  of  appetite,  fever,  stiffness, 
swelling  of  the  legs  and  throat,  and  a  black,  tarry,  or  bloody  dis- 
charge from  the  bowels.  Bloody  urine  and  bloody  nasal  discharge 
were  present  in  some  cases.  Death  occurred  usually  in  from  six  to 
twenty-four  hours  after  the  first  appearance  of  symptoms. 

(5.)  The  chief  lesions  discovered  at  autopsy  were  ecchymoses,  and 
small  and  large  haemorrhagic  areas  in  the  subcutaneous  connective 
tissues,  muscles,  lymph  glands,  and  throughout  the  internal  organs. 
The  cervical  lymph  glands,  heart  muscle,  and  alimentary  canal  were 
most  affected.  The  spleen  was  not  enlarged  nor  darkened  (except 
after  onset  of  decomposition). 

(6.)  From  the  twenty-two  animals  on  which  autopsies  were  made 
the  same  bacillus  was  obtained  from  all  the  tissues  examined.  Where 
the  examination  was  made  immediately  after  death — nine  cases — it  was 
unmixed  with  any  other  organism. 


h.?:morrhagic  septicemia  in  cattle.  719 

(7.)  The  bacillus  was  identified  as  belonging  to  the  hfemorrhagic 
septicFemia  group  of  Hiippe,  best  specifically  designated  as  B.  hovi- 
se2)ticus ;  and  besides  causing  haemorrhagic  septicaemia  in  cattle  (syno- 
nyms— rinderseuche,  buffleseuche,  barbone,  khounnaq,  charbon  blanc, 
ghotwa,  pasteurellosis  bovina,  etc.),  closely  resembles,  if,  indeed,  it 
is  not  identical  with,  the  bacilli  causing  wildseuche,  swine  plague, 
schweineseuche,  rabbit  septicaemia,  chicken  cholera,  grouse  disease, 
duck  cholera,  etc.  The  organism  was  studied  in  direct  coverglass  pre- 
parations, parallel  cultures  in  and  on  various  media,  and  by  inoculation 
of  animals  in  which  the  characteristic  lesions  were  reproduced,  and 
from  the  tissues  of  which  the  inoculated  bacilli  were  recovered  in  pure 
culture. 

(8.)  An  attempt  was  made  to  immunise  cattle  by  the  injection  of 
filtered,  and  later  of  the  killed,  cultures  of  the  bacillus.  The  chief 
difficulties  met  with  were  in  maintaining  the  virulence  of  the  bacillus 
on  artificial  media,  and  in  determining  the  proper  dosage.  The 
experiments  were  too  few,  and  the  results  not  sufficiently  tested  to 
warrant  conclusive  statements  as  to  the  protective  value  of  the  in- 
oculations, but  it  would  appear  that  a  fairly  high  degree  of  immunity 
was  produced. 

(9.)  The  prompt  removal  of  the  dead  animals  and  isolation  of  sick 
ones,  accompanied  by  thorough  disinfection  by  fire,  carbolic  acid, 
corrosive  sublimate,  and  freshly-slaked  lime,  apparently  served  to 
check  each  outbreak  within  a  short  time  after  the  measures  were 
instituted. 


SECTION   XL 
OPERATIONS. 

CHAPTER    I; 
CONTROL    OF    ANIMALS. 

CONTROL    OF    OXEN. 

The  safe  and  efficient  performance  of  surgical  operations  renders 
it  necessary  that  the  animal  should  first  of  all  be  placed  under 
complete  control.  This  precaution,  therefore,  is  the  first  to  merit 
attention.  Animals  are  either  secured  completely  or  to  a  more  or 
less  limited  extent,  according  to  circumstances.  The  ox,  for  example, 
may  be  secured  by  the  head,  one  or  more  limbs  may  be  fastened,  or, 
by  being  placed  in  a  trevis,  the  whole  of  the  animal  may  be  secured. 

PARTIAL     CONTROL. 

(1.)  The  simplest  method  of  securing  the  ox  is  to  grasp  the  nostrils 
or  lower  extremity  of  the  septum  nasi  between  the  thumb  and  index 
finger  of  the  right  or  left  hand  (Fig.  57). 

(2.)  This  method  may  be  rendered  more  complete  by  the  assistant 
passing  his  arm  from  behind  forward  over  the  animal's  head  between 
its  horns,  and  then  grasping  the  nostrils  as  above  described,  whilst 
one  of  the  horns  is  firmly  held  with  the  other  hand  (Fig.  5S). 

(3.)  A  third  method  consists  in  fixing  the  head  to  a  post,  tree, 
fence,  or  other  solid  body,  by  passing  a  rope  round  the  base  of  the 
horns  and  tying  it  to  the  object  selected. 

CONTROL     OF     THE     LIMBS. 

To  prevent  the  animal  kicking  or  moving  about  during  an  opera- 
tion it  is  sometimes  necessary  to  fix  the  limbs.  A  front  leg  may  be 
lifted  as  for  shoeing,  or  may  be  kept  lifted  by  means  of  a  rope  passed 
around  the  fetlock,  over  the  withers,  downward  between  the  front 
legs,  outside  the  forearm,  in  front  of  the  chest  and  inside  the  pastern, 
after  which  one  or  more  turns  may  be  m  de  around  the  pastern  to 
prevent  the  rope  slipping. 


CONTROL    OF    OXEN, 


721 


A  hind  limb  may  be  secured  in  a  simple  way  by  passing  the  end 
of  the  tail  round  it  in  front  of  the  hock  (Fig.  284)  ;  any  violent  and 
extensive  movement  of  the  limb  is  then  necessarily  painful  to  the 
animal  owing  to  the  tension  of  the  tail. 

Greater  security,  however,  is  given  by  passing  a  rope  backward 
and   forward  around  the  hind  legs,  above  the  hocks,  in  the  form  of 


Fio.  284. — Fixiii":  the  head  and  a  hind  hnib. 


a  figure  of  eight  (Fig.  285).  This  does  not  prevent  all  movements  of 
the  hind  limbs,  but  it  limits  them  and  secures  both  animal  and 
operator    from    danger. 

Should  it  become  necessary  to  examine  the  hind  foot  or  inter- 
digital  space,  it  is  useful  at  times  to  pass  a  loop  of  cord  round  the 
leg  in  the  region  of  the  tendo  Achillis,  and 
to  twist  and  tighten  this  loop  by  a  short, 
stout  stick  passed  through  it ;  this  is  the  leg 
twitch  described  in  Dollar's  "  Operative  Tech- 
nique," p.  7. 

For  such  examinations,  however,  the 
animal  is  usually  placed  in  the  trevis,  or  is 
secured  to  the  side  of  a  long  waggon  (Fig.  286). 

To  secure  the  limbs  beneath  the  abdomen 
a  strip  of  webbing  or  a  rope  is  fastened  round 
the  pastern,  passed   between   the   fore   limbs, 

then  in  front  of  the  shoulder  of  the  opposite  side,  over  the  withers  and 
beneath  the  elbow  of  the   same  side,  being  secured  with   a  slip-knot. 

For  castration  iji  the  standing  position  a   hind   and   a    fore   limb 
may  be  fastened  together,  as  shown  in  Fig.  287. 

In  examining  the  sole  of  the  hind  claws,  the  animal's  head  may 
D.c.  3  A 


Fig.  285. 


the  hind 


■22 


OPERATIONS. 


be  secured  to  a   tree,  and  the  hind  limb  lifted  by  a  strip  of  webbing 
or  rope  fixed  to  the  body  of  a  waggon  (Fig.  288). 

GENERAL    CONTROL. 

General  control  in   the  standing  position  can  only  be  made  really 


\ 


Fig.  286. — Fixing  a  front  limb.     Examining  a  hind  foot. 

effective    by   using   the    trevis,   in   which    both  the  head    and   the    fore 
and    hind    limbs   are   secured. 

The  practitioner,  however,  is  often  content  with  much  less  perfect 


Fig.  287. — Fixing  two  limbs  of  one  side  for  the  operation  of  bistournage. 

methods,  using  either  the  so-called  "bulldogs"  or  the  nose  ring,  which 
may  usually  be  so  manipulated  as  to  control  all  but  the  most  dangerous 
animals.     The  nose  ring  is  seldom    employed   except  for  bulls,  which 


CONTROL    OF    OXEN. 


723 


are  usually  ringed  at  an  earl}^  age  ;  the  "  bulldogs  "   can  be  employed 
and  removed  at  will. 

In  inserting  a  nose  ring  the  head  is  securely  fixed,  the  centre 
line  of  the  muzzle  is  grasped  with  the  left  hand,  and  the  septum 
nasi  is  pierced  with  a  straight  bistoury,  the  cutting  edge  being 
turned  in  a  backward  direction ;  the  aperture  being  thus  prepared, 
the  ring  is  introduced  and  fixed.  Some  operators  prefer  to  use  a 
trocar,  slightly  exceeding  in  diameter  the  ring  to  be  worn ;  in  that 
case  the  manual  technique  is  the  same.  The  puncture  is  made,  the 
trocar  alone  is  withdrawn,  and  the  canala  remains  in  situ;  one 
extremity    of    the    ring   is    then   inserted    into    the    canula,    and    both 


S^^^^^^^.     _:=^^&S 


Fig.  288. — Fixing  an  ox  for  the  examination  of  a  hind  Hnib. 


are  drawn  through  the  septum  together.  There  is  no  difficulty  in 
thus  inserting  the  ring,  though  puncture  with  the  trocar  is  perhaps 
rather  less  convenient  than  with  the  bistoury. 

Eelative  control  without  casting  may  also  be  effected  by  attaching 
the  end  of  the  tail  to  the  base  of  the  horns  or  the  head  to  the  cannon 
bone  of  a  front  or  hind  limb.  These  methods,  however,  are  of  little 
value  except  to  prevent  animals  at  grass  from  escaping  entirely  during 
operation. 

CONTROL    BY    CASTING. 

Oxen  should  always  be  cast  on  a  thick  straw  bed  to  avoid  fracturing 
the  horns. 

The  simplest  method  consists  in  using  hobbles  and  ropes,  as  for 
the  horse. 

8  A  2 


724 


Ol'EKATIONS. 


Another,  though  less  practical,  method  consists  in  using  two  long 
ropes,  each  fixed  to  the  base  of  the  horns  and  passed  first  between 
the  front,  then  the  hind  limbs,   round  the  hind  pasterns  from  within 

outwards  and  then  brought  for- 
B  ward  (Fig.  292).    When  the  ropes 

are  drawn  tight  bj'-  assistants 
standing  in  front  of  the  animal, 
the  latter  usually  falls  on  its 
hocks  and  rolls  over  to  the  right 
or  left,  according  to  the  direction 
given  to  it. 

A  third  method  is  particularly 
useful  in  young  or  feeble  animals. 
It  consists  in  fixing  around  the 
horns  a  rope  about  eight,  to  ten 
yards  in  length,  the  free  end  of 
which  is  carried  along  the  upper 
margin  of  the  neck  and  back.  A 
loop  is  formed  embracing  the  base 
of  the  neck,  a  second  behind  the  shoulders  in  the  region  occupied 
by  the  girth,  and  a  third  around  the  flanks  (Fig.  293).  By  pulling  in 
a  backward  direction  the  rope  is  drawn  tight,  and  the  animal  first 
backs  and  afterwards  falls  on  its  hocks,  subsiding  either  to  the  right 
or  left,  as  in  the  case  previously  mentioned. 


Fig,    289.— a,   "  bulldogs  "   operated 
screw  ;  B,  "  bulldogs  "  with  a  sliding 


by   a 
•ing. 


Fig.  290. — Nose  ring  open  for  insertion. 


Fig.  291. — Nose  ring  closed. 


In  using  either  of  these  two  methods  it  is  very  important,  as 
soon  as  the  animal  falls,  to  secure  the  limbs  in  a  certain  way,  ac- 
cording to  the  nature  of  the  operation  to  be  performed.  This  can 
be  effected  with  hobbles  and  ropes  passed  round  the  hocks,  above  the 
knee,  etc. 


Control  of  oxen,  sheep,  goats,  and  pigs. 


725 


CONTROL    OF    SHEEP    AND    GOATS. 

The  above  animals  may  be   secured,  whilst  standing,   by  grasping 
the   head   and  neck   or,    when  cast     by   crossing   the  front  and  hind 


Fig.  292. 

limbs  in  the  form  of  an  X  aii<^^  tying  a  soft  rope  or  piece  of  \vebbin< 
round  the  crossing  of  the  limbs. 


Fig.  293. 


CONTROL    OF    PIGS. 


No  difficulty  is  usually  experienced  in  controlling  young  pigs,  either 
when  standing  or  cast,  only  one  or  two  assistants  being  required,  but 


726  oI'ERAtlONS. 

aged  animals  are  more  difficult  and  more  dangerous  to  deal  with, 
and  by  their  tusks  sometimes  inflict  severe  wounds. 

In  the  standing  position  they  can  be  partially  fixed  by  passing  a 
running  loop  behind  the  canine  teeth  of  the  upper  jaw,  but  should 
the  examination  to  be  carried  out  prove  to  be  of  a  difficult  character 
it  is  best  to  cast  the  animal. 

A  strong  assistant  grasjDs  one  of  the  hind  limbs  b}'  means  of  a 
running  loop,  fixed,  for  example,  above  the  right  hock.  He  rapidly 
slides  his  left  knee  towards  the  front  of  the  left  side  of  the  chest, 
passes  his  left  hand  over  the  withers,  and  by  the  combined  use  of 
his  knees  and  arms  throws  the  animal  on  its  left  side,  controlling 
as  far  as  possible  the  struggles  of  the  right  front  and  hind  limbs, 
which  he  grasps  with  his  hands. 

The  animal  is  then  further  secured  by  rapidly  passing  a  thin  rope 
in  figures  of  eight  around  the  front  and  hind  limbs.  If  necessar}' 
all  four  legs  may  l)e  brought  together  and  fastened  by  a  rope  passed 
round  the  region  of  the  pastern ;  a  muzzle  can  afterwards  be  applied 
to  prevent  biting. 

ANESTHESIA. 

Oxen  rarely  receive  general  anaesthetics,  though  in  certain  obste- 
trical cases  tliey  may  be  necessary.  Ether  and  chloroform  are  given 
by  inhalation,  and  chloral  of  10  to  20  per  cent,  strength  by  intra- 
venous injection.  In  utilising  the  latter  method  the  injection  should 
be  made  slowly,  the  pulse  and  heart  being  closely  scanned  to  prevent 
cardiac  syncope.  The  dose  of  chloroform  varies  with  the  size  of  the 
animal,  2  ounces  often  sufficing  for  a  full-grown  ox.  The  same  methods 
may  be  used  for  sheep,  goats,  and  pigs,  the  doses  being  suitably 
altered.  (For  fuller  particulars  see  Dollar's  "  Operative  Technique," 
pp.  44  to  70.) 

Most  frequently,  however,  the  surgeon  contents  himself  with  pro- 
ducing local  anaesthesia  by  the  injection  of  a  4  to  10  per  cent,  solu- 
tion of  cocaine. 


CHAPTER  li. 
CIRCULATORY  APPARATUS. 

BLEEDING. 

Bovine  animals  are  usually  bled  from  the  superficial  jugular,  or 
the  mammary  vein. 

Bleeding  from  the  Jugular. — The  animal  having  been  suitably 
fixed,  the  jugular  is  raised  by  means  of  a  cord  drawn  tightly  round 
the  base  of  the  neck,  and  the  vessel  is  opened  with  a  fleam  about 
the  middle  of  the  neck. 

The  skin  of  the  ox  being  thick,  a  long-bladed  instrument  is 
necessary.  When  the  bleeding  ceases,  the  cord  is  removed  :  some 
practitioners  take  no  precautions  as  regards  the  wound  ;  it  is  better 
to  insert  a  pin  suture. 

Bleeding  from  the  jugular  may  also  be  performed  with  the  trocar, 
particularly  in  animals  with  fine,  thin  skin. 

Bleeding  from  the  Mammary  Vein. — The  mammary  vein  may  be 
opened  with  the  fleam,  the  straight  bistoury,  or  the  lancet.  The  head 
is  firmly  fixed  and  the  hind  limbs  controlled  by  a  rope  passed  in  a 
figure  of  eight  above  the  hocks. 

In  bleeding  on  the  left  the  operator  places  himself  at  an  angle  to 
the  animal's  side,  opposite  the  hypochondriac  region,  with  his  back 
towards  the  animal's  head,  and  holds  the  fleam  in  his  right  hand. 
To  operate  on  the  right-hand  side  the  fleam  is  held  in  the  left  hand. 

This  method  of  bleeding  always  causes  thrombus  formation,  on 
account  of  the  low  position  of  the  opening  in  the  vein.  The  animal's 
bed  should  be  kept  very  clean,  in  order  to  prevent  any  local  infec- 
tion which  might  cause  hseinorrhagic  or  suppurative  phlebitis.  The 
lancet  or  bistoury  can  only  be  used  in  animals  with  very  fine  skin. 

In  bovine  animals  small  quantities  of  blood  are  sometimes  taken 
from  the  facial  vein  or  the  veins  of  the  ear  or  tail. 

BLEEDING    IN    SHEEP. 

On  account  of  the  quantity  of  fatty  tissue  and  wool  covering  the 
jugular  furrow  in   the   sheep,   bleeding  is  scarcely  practicable  at  that 


728 


CIRCULATORY    APPARATUS. 


point.  The  operation  is  usuall}^  performed  on  the  angular  vein  of 
the  eye,  the  external  saphenous  vein,  or  the  subcutaneous  vein  of 
the  forearm. 

In  operating  on  the  facial  vein  the  animal's  head  is  firmly  held, 
the  operator  compresses  with  the  fingers  of  his  left  hand  the  facial 
vein  at  the  point  where  it.  passes  into  the  maxillary  fissure,  and  with 
a  lancet  opens  the  angular  vein  of  the  eye  or  one  of  the  other 
branches  of  origin  which  project  prominently  beneath  the  skin. 
Bleeding  ceases  as  soon  as  the  pressure  is  relaxed. 

In  the  case  of  the  external  saphenous  vein,  the  vein  is  raised  by 
compressing  the  middle  region  of  the  limb  and  the  vessel  is  opened 
with  a  lancet,  a  little  above  and  towards  the  outside  of  the  hock. 

The  subcutaneous  vein  of 
the  forearm  can  be  raised 
by  compressing  the  fore  limb 
below  the  elbow.  The  vein 
is  visible  throughout  the 
length  of  the  inner  surface 
of  the  radius,  and  can  easily 
be  opened  with  a  lancet. 

'l\K\[M¥IWMJlUIIM/iliR'MW^~^$^^\'\  ^^^    ^  ^^  ^^  ^^^°  possible  to  witli- 

^""' ""        ^  "     "        draw  small  quantities  of  blood 
by  opening  the  marginal  veins 
;V/^)|flM?MiHF  I       ^"'■Si"^        of  the  ear. 

T 


Fig.  294. — Angular  vein  of  the  eye  and 
facial  vein. 


BLEEDING    IN    THE    PIG. 

Breeders  sometimes  bleed 
by  slitting  one  of  the  animal's 
ears  or  cutting  the  tail.      It 
is  preferable  to  bleed  with   a  lancet  from  the  marginal  veins  of  the 
ear,  the  external  saphenous  vein  a  little  above  the  hock,  or  the  sub- 
cutaneous vein  of  the  forearm. 


SETONS,  ROWELS,  PLUGS,  OR    ISSUES. 

Although  the  application  of  setons  is  still  practised  in  horses,  that 
of  "issues"  has  largely  been  given  up  in  bovine  animals,  although 
some  practitioners  still  regard  issues  as  of  considerable  value  and 
as  producing  effects  similar  to,  or  better  than,  those  of  sinapisms. 

They  are  usually  inserted  in  the  region  of  the  dewlap ;  the  materials 
employed  comprise  black  and  white  hellebore,  veratrine  and  stems  of 
clematis. 


SETONS,    ROWELS,   PLUGS,    OR   ISSUES.  729 

Two  methods  are  practised. 

In  the  first,  a  transverse  fold  is  raised  in  the  sldn  of  the 
dewlap,  which  is  divided  with  a  stroke  of  the  bistoury,  leaving  a 
little  aperature  in  the  skin.  By  introducing  the  rounded  ends  of  a 
pair  of  curved  scissors  the  subcutaneous  connective  tissue  is  broken 
down,  leaving  a  little  space  beneath  the  skin,  into  which  the  plug 
is  introduced.  Swelling  takes  places  very  rapidly— in  twenty-four 
to  forty-eight  hours  it  is  very  considerable— and  if  the  substance 
employed  is  violent  in  its  action,  like  hellebore,  it  must  be  with- 
drawn, as  otherwise  considerable  sloughing  takes  place.  To  facilitate 
this  object  a  thread  or  piece  of  string  is  usually  attached  to  the 
plug  before  it  is  inserted. 

In  the  second  method,  the  irritant  material  is  attached  to, 
or  smeared  on,  a  strip  of  broad  linen  tape  which  is  passed  in  pre- 
cisely the  same  manner  as  in  the  horse  (see  Dollar's  "Operative 
Technique,"  pp.  107—111). 


CHAPTER    III. 
APPARATUS    OF    LOCOMOTION. 


The   customary    operations    on    the    apparatus    of    locomotion    are 
almost  entirely  confined  to  the  feet.     They 
I  consist  in  operations  for  sand-crack,  picked- 

up  nail,  stabs  by  nails  and  bruising  of  the 
sole,  elsewhere  mentioned.  As  they  call 
for  no  special  precautions  they  need  not 
be  further  mentioned  here. 


SURGICAL    DRESSING    FOR    A    CLAW. 

The  surgical  dressing  necessitated  by  the 
operation  for  sand-crack,  picked-up  nail,  or 
injury  to  the  heels  is  often  very  difficult  to 
fix  in  the  ox,  and  necessitates  a  support 
round  the  pastern.  It  can,  however,  be 
secured  in  the  following  way : 

The  seat  of  operation  is  covered  with 
small  antiseptic  pads,  which  are  also  ap- 
plied round  the  pastern  and  in  the  inter- 
digital  space.  A  bandage  is  then  passed 
twice  round  the  pastern  and  over  the  pos- 
terior two-thirds  of  the  claw,  as  in  fixing 
the  dressing  used  after  removal  of  the  lateral 
cartilage  in  the  horse.  The  bandage  is  then 
passed  repeatedly  round  the  pastern  in  an 
upward  direction  and  tied  above  the  interdigital  space. 


Fig.  295. — Dressing  for  claw 
after  operation. 


AMPUTATION    OF    THE    CLAW    OR    OF    THE    TWO    LAST 
PHALANGES. 

It  sometimes  happens  that  certain  grave  diseases  in  the  foot  or 
pastern  (stabs  or  picked-up  nails,  panaritium  of  the  interdigital  space, 
necrosis  of  the  ends  of  the  flexor  tendons,  etc.)  are    accompanied   by 


Amputation  of  the  claw  or  op  the  two  last  phalanges. 


'31 


necrosis  of  the  bones,  suppurative  synovitis,  and  even  suppurative 
arthritis  of  the  second  and  first  inter-phalangeal  joints. 

If  carefuH}^  treated  these  forms  of  arthritis  may  disappear,  leaving 
the  joints  anchylosed,  but  unfortunately  the  application  of  the 
necessary  antiseptic  injections  (free  injection  with  warm  boiled  water, 
injection  of  10  per  cent,  iodised  glycerine,  3  per  cent,  carbolic  glycerine 
or  "1  per  cent,  sublimate)  is  difficult  and  costly. 

It   is  better,  in  such  cases,  to  remove   the   claw  or   the    two   last 


Fig.  296. — Anatomical  relations  of 
the  inter-phalangeal  joints. 


Fig.  297. — Disarticulation  of  the 
claw  and  third  phalanx. 


phalanges.  With  antiseptic  precautions  the  stump  heals,  and  recovery 
takes  place  ^Yitllout  the  interminable  suppuration  and  pain  which 
otherwise  cause  such  grave  loss  of  condition. 

(1.)  Disarticulation  of  the  Claw  and  Third  Phalanx. — The 
patient  is  cast  and  suitably  fixed.  The  horn-secreting  coronary  band 
of  the  claw  must  be  preserved. 

First  stage.  The  horny  wall  immediately  beneath  the  coronary  band 
is  thoroughly  thinned  and  the  tissues  are  divided  as  far  as  the  bone. 


732 


APPARATUS   OF   LOCOMOTION. 


Second  stage.  Disarticulation :  The  tendon  of  the  extensor  pedis 
is  divided  and  the  joint  opened.  The  claw  is  pressed  backwards,  and 
first  the  external  and  internal  ligaments,  then  the  flexor  tendons  of 
the  phalanges,  are  divided. 

This  operation  is  of  no  great  use,  because,  on  account  of  the 
position  of  the  joint  and  the  arrangement  of  the  articular  surfaces, 
the  end  of  the  second  phalanx  extends  beyond  the  line  of  section.  To 
avoid  complications,  therefore,  it  is  better  to  remove  the  lower  extremity 


Fig.  298. — Amputation  of  the 
two  last  plialanges.  First 
and  second  phases. 


Fig.  299. — Amputation  of  the  two 
last  phalanges.     Third  phase. 


of  the  second  phalanx,  which,  moreover,  is  always  injured  to  a  greater 
or  less  extent  in  cases  of  pedal  arthritis.  To  effect  this  it  is  only 
necessary  to  draw  back  the  flap  of  skin  a  little  and  rapidly  divide  the 
second  phalange  at  its  upper  third  with  a  fine  saw.  The  points  of 
section  of  the  tendons  and  ligaments  must  be  carefully  examined,  and 
if  they  exhibit  necrosis  should  be  further  shortened. 

The  stump  is  enveloped  in  a  surgical  dressing  fixed  to  the  pastern. 

Amputation  of  the  two  First  Phalanges. — ^When  necrosis  is 
very  serious  and  has  extended  a  long  way  upwards,  it  is  often  better 
immediately  to  resort  to  amputation  of  the  two  last  phalanges. 


AMPUTATION    OF    THE    CLAW    OR    OF    THE    TWO    LAST    PHALANGES.       783 

The  region  is  first  shaved  and  thoroughly  cleansed.  The  coronary 
band  of  the  claw  is  also  preserved  in  this  case. 

First  stage.  The  horn  below  the  coronary  band  is  thoroughly 
thinned  and  the  tissues  are  divided  as  far  as  the  bone. 

Second  stage.  The  skin  covering  the  front  of  the  limb  is  vertically 
incised  from  the  lower  third  of  the  first  phalanx  (Fig.  298)  to  the 
coronary  band  ;  the  skin  is  separated  and  external  and  internal  flaps 
are  formed. 

Third  stage.  The  extensor  pedis  tendon  is  divided,  the  first 
inter-phalangeal  joint  opened,  the  internal  and  external  lateral  liga- 
ments are  divided,  the  claw  is  pressed  backwards,  and  the  flexor 
tendons  are  also  divided. 

To  facilitate  disarticulation,  and  particularly  to  faciHtate  section  of 
the  lateral  ligaments,  the  claw  is  rotated  successively  outwards  and 
inwards. 

According  to  circumstances,  the  lower  extremity  of  the  first 
phalange  is  either  scraped  or  divided  and  the  stumps  of  the  tendons 
are  carefully  trimmed  to  a  regular  shape. 

A  surgical  antiseptic  dressing  is  applied  over  the  whole  of  the 
seat  of  operation. 

Several  other  methods  of  performing  this  operation  will  be  found 
in  Moller   and  Dollar's  "Regional  Surgery,"  pp.  831 — 835, 


CHAPTER    IV. 

DIGESTIVE    APPARATUS. 

RINGING   PIGS. 

This  operation  is  customary  in  countries  where  pigs  are  allo^Yed  to 
roam  more  or  less  at  liberty,  and  it  is  necessary  to  adopt  some  pre- 
caution to  prevent  them  from  uprooting  the  soil  and  thus  causing 
damage,    but   the  practice   tends   nowadays    to   disappear.      It   simply 

consists  in  passing  through  the 
nose  some  object  which  on 
being  rubbed  against  anything 
causes  pain  and  thus  checks 
the  animal's  natural  proclivity. 
Numerous  methods  have 
been  suggested.  One  of  the 
simplest  is  as  follows :  The 
animal  having  been  cast,  suit- 
ably secured  and  muzzled,  two 
thick  iron  wires  sharpened  at 
the  ends  are  passed  through 
the  snout,  and  the  two  ends 
are  then  twisted  together  in 
the  form  of  two  rings.  These 
can,  if  necessary,  be  united. 
Another  method,  perhaps  even  more  efficacious,  consists  in  bending 
a  thick  wire  into  the  shape  of  the  letter  (J,  and  preparing  a  small 
metal  plate  with  two  holes  corresponding  in  position  to  the  distance 
between  the  two  nostrils.  The  ends  of  the  wire,  being  sharpened,  are 
passed  through  the  nostrils  and  securely  united  to  the  metal  plate  by 
being  bent  into  a  spiral  or  simply  at  right  angles. 


Fig.  300. 


Ringing"  the  pig. 


OESOPHAGUS. 


The  operations  practised  on  the  oesophagus  comprise  passage  of 
the  oesophageal  sound  or  probang,  taxis,  crushing  of  foreign  bodies 
within  the  oesophagus,  and  oesophagotomy. 


CESOPHAGUS.  735 


PASSING    THE    PROBANG. 


Passage  of  the  probang  is  called  for  in  cases  of  marked  tympanites, 
suspected  dilatation  or  contraction  of  the  oesophagus,  and  accidental 
obstruction.  Special  or  improvised  instruments  may  be  used,  accord- 
ing to  circumstances. 

The  animal  is  secured  in  a  standing  position  with  the  head 
extended  on  the  neck  and  in  a  straight  line  with  the  body.  A  gag 
is  placed  in  the  mouth  and  the  tongue  is  grasped  and  withdrawn  by 
an  assistant,  whilst  the  operator,  having  carefully  oiled  the  probang, 
passes  it  through  the  gag  towards  the  back  of  the  pharynx. 
Violence  should  be  avoided,  the  probang  being  gently  slid  along 
the  centre  of  the  vault  of  the  palate.  When  the  animal  makes 
swallowing  movements,  the  apparatus  is  slowly  pushed  onwards. 

This  manipulation,  though  simple,  requires  some  dexterity,  because 
at  the  moment  when  the  instrument  enters  the  pharynx  the  animal 
often  thrusts  it  to  one  side  or  the  other  with  the  base  of  its  tongue, 
bringing  it  between  the  molar  teeth,  and  so  crushing,  or  at  least 
injuring  it. 

The  passage  of  hollow  probangs  gives  comparatively  little  relief 
in  cases  of  tympanites,  because  the  probang  is  almost  always  ob- 
structed by  semi-digested  material  from  the  rumen,  or  plunges  into 
the  semi-solid  masses  of  food  contained  therein. 

When  the  oesophagus  is  dilated  at  a  point  within  the  thorax,  the 
progress  of  the  probang  is  checked  by  the  accumulated  food  material, 
and  it  becomes  possible  to  determine  approximately  the  place  where 
the  dilatation  occurs.  In  the  same  way,  should  a  slender  probang 
be  arrested  at  a  given  point  in  the  oesophagus,  this  indicates  that 
therg  is  contraction  of  the  tube  at  that  point. 

In  cases  of  obstruction  the  cupped  probang  is  always  arrested  by 
the  foreign  body.  Efforts  to  thrust  the  latter  onwards  should  always 
be  made  with  great  caution,  otherwise  the  oesophagus  may  be  greatly 
distended  or  its  walls  even  ruptured. 

CRUSHING  THE  FOREIGN  BODY. 

No  attempt  should  be  made  to  crush  a  foreign  body  within  the 
cervical  portion  of  the  oesophagus  unless  it  is  quite  certain  that  that 
body  is  of  comparatively  soft  character.  Crushing  may  be  performed 
by  lateral  pressure  with  the  lingers  within  the  region  between  the  two 
jugular  furrows,  or  mechanical  means  may  be  adopted. 

In  the  latter  case  a  small  piece  of  board  is  applied  to  one  side  of 
the  neck  behind   the  foreign  body,  whilst  gentle  blows  are  given  from 


730  DIGESTIVE   Al'PAUATITS. 

the  opposite  side  with  a  Kttle  wooden  mallet.     Whatever  precautions 
may  be  taken,  however,  this  method  cannot  be  recommended. 

The  same  remark  applies  to  the  use  of  forceps,  the  jaws  of  which 
are  so  fashioned  as  to  escape  pressing  on  the  trachea  whilst  they  grasp 
directl}^  the  foreign  body  through  the  walls  of  the  crsophagus. 

CESOPHAGOTOMY. 

(Esophagotomy,  or  incision  of  the  oesophagus,  is  an  operation  which, 
though  sometimes  necessary,  should  only  be  regarded  as  a  last  resort 
after  all  other  methods  have  failed.  Unfortunately  it  can  be  per- 
formed only  in  the  region  of  the  neck,  and  even  then  the  most 
favourable  point  (viz.,  the  lower  third  of  the  jugular  furrow)  cannot 
always  be  selected,  the  operation  having  to  be  performed  directly 
over  the  foreign  body. 

The  animal  may  be  either  standing  or  lying  down.  The  seat  of 
operation  should  be  thoroughly  cleansed  and  disinfected. 

First  stage.  Incision  through  the  skin  and  subcutaneous  connective 
tissue  above  the  level  of  the  jugular  vein  and  opposite  the  foreign  body. 

Second  stage.  Isolation  of  the  cesophagus  by  dissection  and  tear- 
ing through  of  the  connective  and  fibro-aponeurotic  tissue  at  the  base 
of  the  jugular  furrow. 

Third  stage.  Incision  through  the  oesophagus  for  a  distance  just 
sufficient  to  enable  the  foreign  body  to  be  extracted. 

Fourth  stage.  Suturing  of  the  mucous  membrane,  suturing  of 
the  muscular  walls  of  the  oesophagus,  suturing  of  the  skin,  precautions 
being  taken  to  allow  of  drainage  at  the  lower  part  of  the  operative 
wound. 

SUB-MUCOUS    DISSECTION    OF    THE    FOKEIGN    BODY. 

As  oesophagotomy,  despite  every  precaution,  often  leads  to  fistula 
formation,  Nocard  has  recommended  sub-mucous  dissection  of  the 
obstructive  body,  such  body  being  usually  semi-solid.  This  method 
has  considerable  advantages. 

The  first  and  second  stages  of  the  operation  are  exactly  the  same 
as  those  above  mentioned. 

The  third  stage  consists  in  puncturing  the  walls  of  the  oesophagus 
with  a  straight  tenotome  immediately  behind  the  foreign  body,  as  in 
tenotomy.  A  curved,  button-pointed  tenotome  having  next  been 
introduced  and  passed  with  the  blade  flat  between  the  foreign  body 
and  the  mucous  meml)rane  of  the  oesophagus,  it  is  turned  on  its  axis, 
and  attempts  are  made  to  divide  the  obstruction.  A  few  moments 
are  often  sufficient  to  effect  this,  after  which  the  substance  may  be 
further  broken  up  by  the  fingers. 


kUMEN. 


737 


These  various  methods  may  lead  to  delayed  complications,  such  as 
dilatation  or  contraction  of  the  mucous  membrane  of  the   oesophagus, 
muscular  atrophy  of   the  cesophageal  walls,   oesophageal 
fistula,   and,  sometimes,  abscess  formation. 

RUMEN. 

Two  operations  are  currently  performed  on  the  rumen, 
puncture  and  gastrotomy. 

PUNCTURE    OF    THE    RUMEN. 

Puncture  of  the  rumen  is  essentially  an  urgent  opera- 
tion for  the  relief  of  acute  and  rapidly  progressive  tym- 
panites. It  is  performed  in 
the  left  flank,  at  an  equal 
distance  between  the  last 
rib  and  the  angle  of  the 
haunch,  and  an  inch  or  two 
beyond  the  transverse  pro- 
cesses of  the  lumbar  region. 

First  stage.  Incision  of 
the  skin  to  the  extent  of 
about  one  inch  (not  abso- 
lutely necessary). 

Second  stage.  Puncture 
with  a  sharp  trocar  directed 
forwards,  downwards,  and 
inwards.  In  making  this 
puncture  the  point  of  the 
trocar  is  passed  through 
the  incision,  and  a  sharp 
push  is  given.  The  sensa- 
tion of  resistance  overcome 
indicates  that  the  trocar  has 
penetrated  the  cavity  of  the 
rumen.  Gas  then  escapes. 
When  the  operation  is  com- 
pleted, and  the  canula  is 
being  withdrawn,  care  should 
be  taken  to  press  down  the 

skin  on  either  side  with  the  fingers  of  the  left  hand,  to  prevent  acci- 
dental lifting  and  laceration  of  the  connective  tissue.  Even  so  slight 
an  accident  as  this  might  cause  serious  complications  at  a  later  stage. 

In  the  absence  of  a  trocar,  and  in  cases  of  extreme  urgency,  the 
D.c.  3  B 


Fig.  301. — Trocar  for  puncture  of  the  rumen. 


738  DIGESTIVE    APPARATUS. 

rumen  may  be  directly  punctured  with  a  straight  bistoury,  and 
after  the  punctured  wound  is  shghtly  enlarged,  but  before  the  blade 
of  the  bistoury  is  withdrawn,  an  improvised  canula,  consisting  of  a 
hollow  elder  twig,  may  be  introduced.  Were  the  blade  of  the  bistoury 
withdrawn  before  the  introduction  of  the  canula,  the  rumen  would 
be  displaced,  and  the  points  punctured  would  no  longer  correspond.  ' 

Complications,  such  as  respiratory  or  circulatory  syncope,  attacks 
of  vertigo,  etc.,  have  been  noted,  but  these  in  reality  are  very  rare. 

Subcutaneous  Emphysema. — When  the  canula  is  carelessly  removed, 
and  the  subcutaneous  connective  tissue  is  torn,  local  emphysema  may. 
occur  if  the  pressure  of  gas  in  the  rumen  is  very  great.  This  gas 
enters  the  puncture,  proceeds  along  the  connective  tissue,  particularly 
the  subcutaneous  connective  tissue,  and  causes  crepitant  subcutaneous 
emphysema,  very  easy  to  recognise.  This  emphysema  may  remain 
localised  in  the  neighbourhood  of  the  puncture  and  gradually  become 
absorbed.  It  may,  however,  extend  to  the  whole  of  the  flank  or  even 
beyond,  and  in  exceptional  cases  bring  about  generalised  subcutaneous 
emphysema.  Such  very  extensive  emphysema  as  this  rarely  becomes 
reabsorbed  without  complications. 

The  suppuration  which  follows  puncture  of  the  rumen  may  assume 
one  of  two  forms  : — 

(a)  That  of  a  little  local  abscess  at  the  point  of  puncture,  when 
foreign  matter  or  the  microbes  of  suppuration  have  been  left  in  the 
path  made  by  the  withdrawal  of  the  canula.  Such  abscesses  are  of 
little  importance.  They  rapidly  heal  if  opened  and  treated  with  anti- 
septic injections. 

(h)  That  of  diffuse  subcutaneous  or  interstitial  suppuration  following 
accidental  emphysema. 

The  pressure  of  gas  forces  fragments  of  food  material  between  the 
layers  of  tissue,  and  suppuration  is  set  up,  the  pus  escaping  by  a  fistula 
at  the  point  of  puncture.  Such  suppuration  is  decidedly  dangerous, 
because  it  may  result  in  necrosis  of  the  aponeurotic  layers  of  the 
small  oblique  muscle,  in  which  case  recovery  is  tedious  and  uncertain. 

Treatment  consists  in  laying  open  the  orifice  and  fistula,  and 
making  a  counter  opening  at  the  lowest  point  of  the  swelling.  Free 
drainage  and  abundant  irrigation  with  boiled  water  at  the  body  tem- 
perature, followed  by  antiseptic  injections,  complete  the  treatment. 

Peritonitis  is  not  altogether  exceptional  as  a  sequel  to  puncture 
of  the  rumen,  if  ordinary  precautions  are  neglected  or  if  infective 
material  or  fragments  of  food  pass  into  the  peritoneal  cavity. 

At  first  the  condition  is  usually  local,  but  it  may  extend  and  assume 
the  form  of  general  peritonitis  two  or  three  weeks  later.  The  symptoms 
are  those  of  acute  peritonitis. 


GASTROTOMV 


739 


Speaking  generally,  however,  puncture  of  the  rumen  in  cattle  and 
sheep  is  seldom  followed  by  any  complication, 

GASTROTOMY. 

Gastrotomy  is  performed  for  the  relief  of  impaction  of  the  rumen 
and  to  remove  foreign  bodies,  such  as  linen,  nails,  bits  of  leather,  etc., 
which  have  been  swallowed. 

A  vertical  or  slightly  oblique   incision  is    made  in    the  left  flank. 


Fig.  302. — Gastrotomy.     Va,  Skin  ;  Im,  2m,  muscular  layers  ;  Pe,  peritoneum  ; 
R,  rumen,  showing  line  of  incision. 


extending  from  the.  fourth  transverse  process  of  the  lumbar  vertebra 
towards  the  last  rib.     The  operation  comprises  the  following  stages : — 

First  stage.  Incision  through  the  skin  for  a  dis- 
tance of  from  6  to  10  inches,  according  to  the  size  of 
the  animal. 

Second  stage.  Incision  through  the  muscles  and 
peritoneum  and  torsion  of  any  small  muscular  arte- 
rioles, which  may  be  divided. 

Third  stage.  Fixation  and  immobilisation  of  the 
rumen  with  from  four  to  six  sutures  (Fig.  303). 

Fourth  stage.  Vertical  incision  into  the  rumen ; 
manual  examination  of  the  cavity  and  its  contents. 

Formerly  the  operation  was  confined  to  these 
stages.  In  such  cases  localised  adhesive  peritonitis 
follows,  causing  the  rumen  to  adhere  to  the  internal 
surface  of  the  abdominal  wall,  and  the  fistula  con- 
tinues in  existence  for  months  before  complete  cicatrisation.  It  is 
better,  therefore,  to  insert  sutures  in  the  rumen,  in  order  to  secure 
more  rapid  and  complete  closure. 

Fifth  stage.     Suture  of  the  rumen  with  carbolised  silk.     The  lips 

3  B  2 


Fig.  303. 


740  DIGESTIVE    APPARATUS. 

of  the   wound   sboukl  be  brought  together  face  to  face,   or  they  can 

be  shglitly  inverted,  but  the  sutures  should  only  pass  through  the 
peritoneum  and  muscular  coats,  avoiding  the 
mucous  coat.  If  the  silk  threads  pass  through 
the  mucous  membrane  and  come  in  contact 
with  the  gas  in  the  upper  zone  of  the  rumen 
they  are  rapidly  macerated,  and  the  sutures 
tear  out  before  the  wounds  can  heal.  The 
rumen  should  always  be  kept  fixed  to  the  ab- 
dominal wall  towards  the  upper  and  lower  ex- 
tremities of  the  operative  wound,  in  order  to 
avoid  displacement  and  occurrence  of  perito- 
nitis. For  a  similar  reason  the  passing  of  the 
silk  sutures  should  be  preceded  by  careful  dis- 
FiG.  304.  infection  of  the  operative  wound,  and  free  wash- 

ing of  the  parts  with  boiled  water. 
The  operation  is  concluded  by  bringing  the  skin  together  with  a 

few   silk   sutures    and   inserting   a   strip   of   iodoform   gauze   into   the 

lower  portion  of  the  wound,  to  serve  as  a  drain. 

LAPAROTOMY. 

Laparotomy  is  comparatively  seldom  performed  on  animals  of  the 
bovine  species,  though  it  may  become  necessary  in  dealing  with  cases 
of  hernia,  uterine  torsion  (where  direct  taxis  is  called  for),  Cesarean 
section,  invagination  or  strangulation  of  the  intestine,  and  under  a 
few  other  exceptional  circumstances. 

If  simple  exploration  is  aimed  at,  the-  operation  is  most  con- 
veniently performed  from  the  right  flank  with  the  animal  in  a  stand- 
ing position,  but  should  a  prolonged  operation  be  contemplated  the 
animal  should  be  cast.  The  incision  varies  in  length,  according  to 
circumstances,  from  8  to  16  inches,  and,  like  that  in  gastrotom}^, 
should  correspond  in  direction  with  the  fibres  of  the  small  oblique 
abdominal  muscle;  the  seat  of  operation  should  previously  be  washed, 
shaved,  and  disinfected. 

The  operation  comprises  the  following  stages  : — 

First  stage.     Incision  of  the  skin. 

Second  stage.     Incision  through  the  muscles  and  peritoneum. 

Third  stage.  Exploration,  inspection,  palpation,  extraction  or 
ablation,  etc. 

Fourth  stage.  Suture  of  the  peritoneal  opening,  the  lips  being 
brought  together  face  to  face. 

Fifth  stage.  Suture  of  the  muscles  and  the  skin.  It  is  some- 
times advisable  to  insert  a  drain  of  iodoform  gauze  under  the  skin. 


HERNIA. 


741 


In  small  animals,  such  as  the  sheep,  goat,  and  pig,  laparotomy 
is  more  easily  practicable,  and  can  be  performed  either  in  the  right 
flank  or  towards  the  white  line.  The  stages  of  operation  are  exactly 
the  same,  but  after  operating  near  the  white  line  it  is  extremely 
important  to  use  numerous  and  strong  sutures,  and  afterwards  to 
apjDly  a  suspensory  bandage  around  the  abdomen,  securing  it  above 
the  loins. 

HERNIA. 

The  situation  and  nature  of  the  hernia  determine  whether  or  not 
a  radical  cure  should  be  attempted. 

When  a  decision  has  been  arrived  at  the  seat  of  operation  must  first 
of  all  be  thoroughly  cleansed 
and  disinfected.  The  animal 
is  cast  in  a  convenient  posi- 
tion, and  a  general  anaesthetic 
is  given  or  a  subcutaneous  in- 
jection of  1  per  cent,  cocaine 
solution  administered. 

The   operation  comprises  : — 

First  stage.  Incision  through 
the  skin  covering  the  hernial 
sac,  opposite  the  orifice  of  the 
hernia. 

Second  stage.  Isolation  of 
the  hernial  sac. 

Third  stage.  Reduction  of 
the  hernia  and  breaking  down 
of  any  adhesions  that  may 
exist. 

Fourth  stage.  Resection  of 
the  sac  and  obliteration  of  the 
peritoneal  orifice  by  suture  and 
ligature. 

Fifth  stage.  Suturing  of 
the   muscles   and    skin,   and    application  of   a   surgical    dressing. 

In  practice,  the  deep  sutures  should  be  of  bichromatised  catgut 
or  silk,  and  the  skin  sutures  of  catgut  ligature  or  aseptic  silk. 


INGUINAL    HERNIA    IN    YOUNG    PIGS. 


One  of  the  most  frequent  forms  of  hernia  which  the  practitioner  is 
called  on  to  treat  is  inguinal  hernia  in  young  pigs.  Although  this 
allows   little    tendency  towards  strangulation  it  is  always  desirable  to 


742  DIGESTIVE    APPARATUS. 

operate,  as  otherwise  the  patients  develop  badl3\  There  is  no  diffi- 
culty in  this,  though  the  animals  must  be  cast  and  placed  on  their 
backs,  the  hind  quarters  being  raised   (Fig.  305). 

First  stage.  A  longer  or  shorter  cutaneous  incision  over  the  neck 
of  the  hernia  and  along  its  greater  curvature. 

Second  stage.  Isolation  of  the  hernial  sac,  consisting  of  the  dilated 
internal  sheath. 

Third  stage.  Direct  reduction  of  the  hernia  without  opening  the 
sac,  provided  no  adhesions  occur,  or,  in  the  event  of  adhesions,  after 
incision  of  the  sac. 

Fourth  stage.  Torsion  of  the  hernial  sac  and  of  the  testicular 
cord  up  to  the  inguinal  ring.  Application  of  a  catgut  or  silk  liga- 
ture around  the  sac  and  cord  at  the  level  of  the  inguinal  ring. 

Fifth  stage.  Fixation  of  the  ligature  to  the  lips  of  the  ring. 
Suture  of  the  skin  wound,  and  drainage  of  the  wound  with  a  strip 
of  iodoform  gauze. 

IMPERFORATE    ANUS. 

This  anomaly  of  development,  which  is  not  uncommon,  presents 
two  different  degrees  of  development. 

In  the  first  degree  the  rectum  is  well  formed,  and  extends  as  far 
as  the  skin  below  the  base  of  the  tail. 

In  the  second  the  rectum  is  incomplete  or  non-existent,  the 
floating  colon  terminating  in  a  blind  end  at  the  entrance  to  the 
pelvis. 

In  calves,  lambs,  and  young  pigs  very  often  imperforate  anus  is 
not  diagnosed  until  the  second  or  third  day  after  birth.  Defecation 
cannot  occur,  and  death  is  inevitable  unless  an  artificial  anus  be 
established. 

First  Degeee. — The  patient  loses  appetite,  the  abdomen  remains 
distended,  and  on  examination  of  the  anal  region  a  doughy  swelling 
is  felt,  which  projects  backwards  when  the  animal  strains.  The 
operation  is  quite  elementary,  and  always  proves  successful. 

First  stage.  The  skin  beneath  the  tail  is  incised  vertically;  the 
rectal  cul-de-sac  projects  towards  the  incision. 

Second  stage.  The  rectal  cul-de-sac  is  punctured,  the  contents 
are  removed,  and  the  rectum  and  skin  united  by  a  few  sutures.  An 
anus  is  thus  established,  though  there  is  no  sphincter. 

Second  Degree. — The  general  symptoms  are  similar,  though  very 
often  the  little  patient  shows  symptoms  of  atrophy  or  arrest  in 
development.     The  operation  is  somewhat  complicated. 

First  stage.  Vertical  incision  through  the  skin  at  the  base  of 
the  tail. 


PROLAPSITS    AND    INVERSION    OF   THK    RECTUM. 


743 


Second  stage.  Digital  exploration  of  the  cavity  of  the  pelvis 
after  breaking  down  of  the  layers  of  connective  tissue,  and  search 
for  the  blind  end  of  the  floating  colon.  When  discovered,  the  colon 
is  grasped  between  the  jaw^s  of  a  clamp  or  large  forceps  with  sroooth 
jaws,  and  gently  drawn 
towards  the  opening. 

Third  stage.  Punc- 
ture of  the  blind  end  of 
the  colon,  and  suture  of 
the  latter  to  the  cutaneous 
wound,  as  in  the  former 
case. 

A  third  condition  may 
exist,  where  the  ex- 
tremity of  the  colon  re- 
mains within  the  abdo- 
men. Operation  by  way 
of  the  pelvis  then  proves 
unsuccessful.  If  con- 
sidered advisable,  an 
opening  may  be  made 
through  the  right  flank, 
so  that  the  floating  colon 
may  be  brought  to  the 
surface  and  an  artificial 
anus  produced  in  this 
region. 

An  incision  1  or  2 
inches  in  length  is  made 
beloW'  the  haunch,  to 
allow  of  the  introduc- 
tion of  the  index  finger, 
with  which  the  loop  is 
sought.  The  colon  is  withdrawn,  and  the  operation  thenceforth  is  as 
above  described. 


Fia.  806.— 1,  Prolapse  of  the  rectum  and  vagina ; 
2,  schema  showing  the  relations  of  the  layers  of 
the  rectum  in  prolapse  ;  3,  first  jshase,  showing 
manner  of  fixing  the  superposed  layers  of  tissue 
by  inserting  four  sutures — the  left  index  finger  is 
inserted  into  the  rectum  in  order  to  manipulate 
the  parts  ;  4,  interrupted  sutures  inserted  around 
the  bowel  after  amputation. 


PROLAPSUS    AND    INVERSION    OF    THE    RECTUM. 

This  condition  occurs  in  young  pigs  in  various  degrees.  The 
necessity  for  reduction  depends  on  the  extent  to  which  tearing  or 
gangrene  of  the  mucous  membrane  has  progressed.  The  inverted 
portion  is  carefully  washed,  freely  dressed  with  some  non-irritant 
fatty  substance  such  as  vaseline,  and  progressively  pushed  back  with 
the  thumbs  and  index  fingers  of   both   hands   applied   flat   on   either 


744  DIGESTIVE    APPARATUS. 

side  of  the  anus.  To  facilitate  reduction  it  is  best  to  check  the 
animal's  expulsive  efforts  by  placing  a  gag  in  the  mouth. 

In  more  aggravated  cases,  when  prolapsus  of  the  rectum  has 
returned  several  times  and  the  mucous  membrane  is  gangrenous  in 
places  so  that  such  a  complication  as  peritonitis  of  the  pelvic  cavity 
is  to  be  feared,  it  is  better  to  amputate  the  prolapsed  portion. 

The  animal  is  secured  either  standing  or  lying  down,  and  a  large 
enema  is  administered  to  remove  the  contents  of  the  rectum.  The 
herniated  portion  of  bowel  is  carefully  examined,  for  it  sometimes 
happens  that  loops  of  intestine  have  become  lodged  in  the  dilated 
peritoneal  sac,  produced  by  displacement  of  the  rectum.  In  such 
cases  reduction  should  be  effected  before  anything  more  is  done,  and 
for  this  purpose  the  patient's  hind  quarters  should  be  lifted  or  even 
suspended. 

The  operation  for  removal  comprises  two  stages  : 

(1.)  Fixation  of  the  two  layers  of  bowel  by  the  passage  of  either 
two  or  four  sutures  about  J  an  inch  behind  the  anus. 

(2.)  Circular  amputation  of  the  sutured  tissues ;  insertion  of  inter- 
rupted silk  sutures  through  the  lips  of  the  wound;  reduction.  The 
patient  is  restricted  to  milk  diet  for  a  week.  Laxative  gruels,  etc., 
may  then  be  given. 

The  complication  to  be  feared  is  peritonitis  of  the  pelvic  cavity 
owing  to  the  sutures  tearing  out  and  allowing  infective  material  to 
pass  from  the  bowel  into  the  cavity. 

Slight  cases  of  prolapsus  might  possibly  be  treated  by  the  injection 
in  lines  of  melted  parafftn  wax  beneath  the  mucous  membrane  of  the 
last  part  of  the  bowel.  The  injection  is  made  by  means  of  a  large 
syringe  provided  with  a  long  needle,  the  needle  being  gradually  with- 
drawn as  the  melted  wax  is  expressed.  Four  "  pillars "  of  wax  are 
usually  injected  at  equidistant  points.  As  they  solidify  they  support 
the  bowel  and  prevent  the  recurrence  of  the  prolapse.  The  operation, 
however,  is  delicate,  and  scarcely  to  be  recommended  in  pigs.  More- 
over, in  man,  in  whom  it  has  chiefly  been  practised,  the  deferred  results 
liave  not  always  proved  satisfactory. 


CHAPTER    V. 
RESPIRATORY    APPARATUS. 

TREPHINING    THE    FACIAL    SINUSES. 

This  operation  is  necessary  ^Yhen  pns,  tumours,  or  parasites  exist 
within  the  sinuses,  and  in  some  cases  where  tumours  form  within 
the  nasal  cavities,  etc. 

TEEPHINING     THE     HORN     CORE. 

This  cavity  is  opened  in  front,  at  the  base  of  the  horn,  about 
f  of  an  inch  above  the  keratogenous  band. 

FRONTAL     SINUS. 

The  frontal  sinus  may  be  trephined  at  one  of  two  points,  that  is, 
either  towards  its  highest  or  lowest  extremity. 

In  the  former  case  the  point  selected  is  in  the  direction  of  the 
axis  of  the  horn  core,  about  f  of  an  inch  nearer  the  middle  line  than 
the  base  of  the  horn  itself. 

The  animal  should  be  cast. 

First  stage.  A  V-shaped  incision  |  of  an  inch  long  on  each  side 
is  made  through  the  skin  and  subjacent  tissues,  exposing  the  bone. 

Second  stage.  The  skin  and  periosteum  are  dissected  away  and 
reflected  upwards. 

Third   stage.     Trepanation. 

The  lower  portion  of  the  cavity  is  trephined  within  the  angle 
formed  by  a  transverse  line  uniting  the  upper  margin  of  the  orbits 
and  the  inner  margin  of  the  super-orbital  foramen. 

The  stages  are  precisely  the  same  as  those  above  described. 

MAXILLARY     SINUS. 

In  adult  animals  the  maxillary  sinus  is  opened  immediately  above 
the  maxillary  tuberosity.  In  the  young  the  point  selected  is  |  of  an 
inch  higher. 


746  RESPIRATORY    APPARATUS. 


TRACHEOTOMY. 

In  bovine  animals  tracheotomy  is  only  performed  in  urgent  cases, 
in  order  to  ward  off  aspliyxia  or  to  facilitate  some  other  operation 
on  the  upper  air  passages.  It  is  performed  exactly  as  in  the  horse, 
the  animal  either  standing  or  lying  down.  In  the  former  case,  the 
animal  may  be  placed  in  the  trevis,  but  two  strong  assistants  hold- 
ing the  animal's  head  and  nose  by  means  of  "bulldogs"  are  often 
sufficient. 

To  prevent  the  animal  from  striking  out  with  the  front  legs,  a 
rope  is  passed  above  and  around  the  knees  in  the  form  of  the  figure 
8  ;  the  animal  is  backed  into  a  corner,  and  operation  is  then  quite 
safe. 

Large  animals  must  be  cast  or  placed  in  the  trevis. 

The  seat  of  operation  should   be  washed,  shaved,  and  disinfected. 

The  operation  may  be  divided  into  four  stages. 

First  stage.  Vertical  median  incision  about  2  inches  long 
through  the  skin  at  the  height  of  the  upper  third  of  the  trachea. 

Second  stage.  Separation  with  a  blunt  director  of  the  muscles 
covering  the  trachea.  Incision  through  the  pretracheal  connective 
tissue. 

Third  stage.  Circular  or  elliptical  opening  through  the  trachea 
of  a  size  corresponding  to  that  of  the  tracheotomy  tube. 

Fourth   stage.     Insertion  of  the  tracheotomy  tube. 


CHAPTER    VI. 
GENITOURINARY    ORGANS. 

In  the  domestic  ruminants  the  penis  exhibits  a  peculiar  S-shaped 
curve,  situated  in  the  sub-pubic  region  (Fig.  226),  so  that  when 
operation  on  the  urethra,  or  even  on  the  extremity  of  the  penis, 
becomes  necessary  the  organ  must  first  of  all  be  withdrawn. 

The  manipulation  is  as  follows  : — 

The  animal  having  been  fixed  by  the  head  and  front  legs  in  a 
standing  j)osition,  and  if  possible  thrust  against  a  wall,  the  operator 
stands  on  its  left  side.  With  his  right  hand  he  seizes  the  penis 
and  the  skin  immediately  in  front  of  the  scrotum  and  pushes  them 
forward  in  the  direction  of  the  opening  of  the  sheath. 

The  extremity  is  nipped  between  the  first  fingers  of  the  left  hand, 
and  to  prevent  the  glans  slipping  or  escaping  when  the  right  hand 
is  removed  (for  the  purpose  of  taking  a  fresh  hold  of  the  body  of 
the  penis  further  back)  the  operator  may  reverse  the  free  extremity 
of  the  penis  so  that  it  forms  a  loop,  and  thus  secure  a  firmer  hold. 
With  the  right  hand  the  skin  is  thrust  backward,  a  new  portion 
of  the  sheath  fixed,  and  the  organ  again  pushed  forward.  In  this 
way  the  penis  is  gradually  extended.  When  the  animal  is  cast,  this 
manipulation  is  much  easier. 

URETHROTOMY    IN    THE    OX. 

Urethrotomy  consists  in  incising  the  urethra,  usually  for  the  pur- 
pose of  extracting  a  foreign  body  or  calculus  which  impedes  micturi- 
tion. In  the  ox,  calculi  may  become  fixed  either  in  the  intra-pelvic 
portion  of  the  urethra,  though  this  is  very  rare  ;  in  the  ischial 
curvature,  or  more  commonly  at  some  point  in  the  S-shaped  curve 
of  the  penis ;  or  sometimes  even  within  the  sheath  itself. 

Urethrotomy  is  performed  in  the  ischial  or  scrotal  region,  accord- 
ing to  the  point  where  the  obstruction  exists. 

ISCHIAL     UEETHROTOMY. 

Urethrotomy  is  performed  in  the  ischial  region  either  to  displace 
or   indirectly   to    abstract   a    foreign    body   fixed   in   the   membranous 


748  GENITO-UKINARY    ORGANS. 

portion  of  the  urethra,  or  directly  to  remove  one  from  the  spongy- 
portion  opposite  the  ischial  curve. 

Calculi  fixed  in  the  intra-pelvic  region  are  detected  by  rectal 
exploration. 

The  exact  position  of  the  foreign  body  is  determined  by  inspec- 
tion and  palpation,  whilst  distension  of  the  urethra  by  urine  may 
be  noted  even  before  more  striking  symptoms  appear. 

The  urethra  can  be  incised  by  one  of  three  methods. 

The  animal  should  be  secured,  if  possible,  in  the  standing 
position. 

The  first  method,  which  dates  back  to  very  early  times,  consists 
in  puncturing  the  urethra  at  one  stroke  with  the  fleam  or  lancet, 
and  Oldening  it  more  freely,  after  introducing  a  grooved  director. 
This  method  is  very  useful  where  rupture  of  the  bladder  is 
imminent. 

The  extraction  of  a  calculus  fixed  in  the  ischial  region,  or  the 
manipulation  of  an  obstruction  at  any  other  point,  can  afterwards 
be  undertaken. 

Second  method.  A  second  method  consists  in  incising  the  sub- 
cutaneous tissues,  layer  by  layer,  until  the  urethra  is  reached  at 
the  ischial  arch. 

The  operation  is  terminated  by  puncturing  the  urethra  and 
enlarging  the  incision  in  an  upward  direction  after  passing  a  grooved 
director.  This  method  minimises  haemorrhage  and  urinary  infiltra- 
tion. By  previously  injecting  cocaine,  the  operation  may  be  made 
practically  painless. 

Third  method.  Puncture  of  the  urethra  by  a  single  sti'oke  with 
a  straight  bistoury  at  the  ischial  arch. 

The  opening  is  enlarged  in  an  upward  direction  with  the  same 
instrument. 

SCROTAL     URETHROTOMY. 

Scrotal  urethrotomy  is  necessary  when  the  calculus  is  situated 
in  one  of  the  S-shaped  curves  of  the  penis  or  nearer  the  glans. 

The  operation  is  facilitated  by  casting  the  animal  and  with- 
drawing the  penis  from  the  sheath,  but  as  there  is  considerable 
danger  of  rupturing  the  bladder  when  casting  an  animal  with 
marked  distension  of  that  organ,  the  more  serious  operation  should  be 
preceded  by  puncturing  the  urethra  with  a  fleam  at  the  ischial  arch. 

By  repeated  moderate  traction  on  the  extremity  of  the  glans,  the 
S-shaped  curve  can  be  obliterated  and  the  anterior  portion  of  the 
penis  withdrawn  beyond  the  sheath. 

One  of  two  conditions  may  exist, 


PASSAGE   OF   THE   CATHETER    AND   URETHROTOMY    IN   THE   RAM.      749 

First  case.  Where  the  calculus  is  in  the  anterior,  extra-prepubic 
portion,  it  is  removed  through  an  incision  made  directly  over  it. 
After  extraction  and  disinfection,  one  or  two  sutures  are  inserted. 

Second  case.  Should  the  calculus  be  situated  in  that  portion  of 
the  penis  which  remains  within  the  sheath  after  the  fullest  with- 
drawal of  the  organ,  it  is  necessary  to  proceed  as  follows : — 

(1.)  The  skin  covering  the  sheath,  the  subcutaneous  tissue,  and 
the  mucous  membrane  are  first  incised  for  a  length  of  from  IJ  to 
If  inches. 

(2.)  The  penis  is  drawn  through  this  opening;  an  incision  is  made 
directly  over  the  calculus,  dividing  the  fibrous  layer,  erectile  tissue 
and  mucous  membrane  of  the  urethra ;  the  parts  are  disinfected  and 
the  wounds  closed  with  sutures. 

With  ordinary  antiseptic  precautions  little  danger  is  to    be  feared. 

Even  should  infiltration  of  urine  occur,  the  operator  need  not  be 
unduly  anxious,  for,  provided  the  parts  are  punctured  or  scarified 
early,  recovery  usually  follows. 

PASSAGE  OF  THE  CATHETER  AND  URETHROTOMY  IN 
THE  RAM. 

Obstruction  of  the  urethra  in  rams  is  more  commonly  caused  by 
deposits  of  gravel  than  by  single  large  calculi.  It  is  generally  found 
in  highly-fed  animals,  in  which  gravel  accumulates  and  becomes 
massed  together  at  some  point  in  the  canal,  often  near  the  free 
extremity,  where  it  forms  a  plug,  causing  complete  retention  of  urine. 
In  other  cases  this  retention  is  due  to  a  mass  of  sediment  formed 
by  vesical  mucus  and  fine  gravel  which  collects  about  the  neck  of 
the  bladder. 

Three  operations  have  been  advised  for  the  removal  of  this  con- 
dition : — 

(1.)  Section  of  the  Appendix  of  the  Penis. — When  the  disease  is 
just  appearing  the  sedimentary  material  may  be  collected  at  the 
anterior  extremity  of  the  penis  behind  the  appendix.  The  shepherds 
in  such  cases  remove  the  extremity  of  the  penis.  The  resistance 
disappears,  the  plug  formed  of  gravel  yields  to  the  pressure  of  urine, 
and  micturition  occurs  as  usual.  Excision  of  the  appendix,  however, 
incapacitates  the  ram  for  service. 

(2.)  Passage  of  the  Catheter. — Passage  of  the  catheter  has  been 
recommended  for  the  removal  of  deposits  of  gravel  in  the  urethra, 
but  it  seems  a  very  questionable  method. 

Should  it  be  determined  on,  the  animal  must  be  placed  on  its 
back.  The  penis  is  then  withdrawn  and  the  double  S-shaped  curve' 
is   obliterated.      An   incision    is    made     over    the    canal    behind  the 


VdO 


GENITO-URINARY    ORGANS. 


appendix  and  a  soft  gutta-perclia  sound  is  passed.  The  sabulous 
accumulation  is  thus  dispersed. 

(3.)  Urethrotomy. — Scrotal  urethrotomy  may  be  performed  as  in 
the  ox. 

Ischial  urethrotomy  is  impracticable  in  very  fat  animals,  but  when 


Fig.  307. — Passing  the  catheter  in  the  cow. 

the   obstruction  is  about    the  neck  of   the  bladder,  and    the    animal's 
condition  admits  of  it,  this  operation  may  be  performed. 

The  patient  is  fixed  on  its  back,  and  a  metallic  or  gutta-percha 
sound  is  passed  into  the  urethra.  The  tissues  are  incised  layer  by 
layer   in    the   direction    of   the   sound.      Once   the    urethra    has   been 


<0^ 


Sl 


Fig.  308. — Catheter  for  cows. 


opened  the  soft  magma  may  be   washed  out  of  the  bladder  by  a  free 
injection  of   boiled  water  or  similar  aseptic  liquid. 


PASSAGE    OF    THE    CATHETER    IN    THE    COW. 

It  sometimes  becomes  necessary  to  examine  the  bladder  of  the  cow. 

There  is  an  obstacle,  however,  to  the  introduction  of  the  sound 
into  the  urethral  canal.  The  meatus  urinarius  is  covered  by  a  little 
valve  which  springs  from  the  lower  wall  and  forms  behind  the  real 
opening  of  the  urethra  a  cul-de-sac,  into  which  the  point  of  the 
catheter  is  apt  to  pass.  The  instrument  usually  employed  is  of 
gutta-percha,  glass,  or,  better  still,  of  metal,  as  more  easily  sterilised 
(Fig.   308).     It  is  held  like  a  pen,   and  is  directed  along  the  floor  of 


CASTRATION.  V5l 

the  vagina  as  far  as  the  02)eDing  of  the  meatus,  being  guided  by  the 
index  finger  of  the  left  hand,  which  has  previously  been  introduced. 
The  point  being  very  slightly  depressed,  it  enters  the  cul-de-sac.  It 
is  then  only  necessary  to  reverse  the  movement,  that  is  to  say,  raise 
the  point,  whilst  gently  pressing  forward  ;  a  slight  resistance  is  felt 
and  the  sound  enters  the  bladder.  If  necessary  the  little  valve  may 
be  held  down  by  gently  pressing  on  it  with  the  point  of  the  left 
index  finger. 

It  is  sometimes  an  advantage  to  expose  the  seat  of  operation.  In 
such  cases  the  lips  of  the  vulva  and  the  walls  of  the  vagina  may 
be  separated  by  retractors  or  by  the  use  of  a  speculum. 

CASTRATION. 

Castration  is  performed  for  the  purpose  of  removing  the  repro- 
ductive power,  either  by  obliterating  the  testicle  or  ovary  or  by 
suppressing  their  functions. 

In  ruminants,  the  testicles  are  elongated  and  placed  in  a  vertical 
position,  the  upper  portion  of  the  scrotum  presenting  a  constriction 
and  the  whole  scrotal  mass  resembling  in  shape  a  cone  with  its  base 
downwards. 

CASTRATION    OF    THE    BULL    AND    RAM. 

These  two  animals,  when  destined  for  slaughter,  are  usually 
castrated  either  at  birth  or  at  latest  two  or  three  months  afterwards. 
In  Normandy,  in  Fi-tinche-Comte,  and  in  England  breeders  castrate 
young  bulls  by  torsion  of  the  cord. 

Two  incisions  about  1]  to  If  inches  in  length  are  made  on  the 
lower  extremity  of  the  scrotum.  The  testicles  are  enucleated  and 
the  testicular  cords  seized  with  two  pressure  clamps,  with  which 
torsion  is  effected.  In  the  South  of  France,  in  Auvergne,  and  in  the 
Limousin,  bulls  intended  for  working  are  not  castrated  until  after  the 
lapse  of  some  months,  on  account  of  the  influence  which  the  testicles 
have  on  the  development  of  the  bones  and  muscles.  Such  animals 
are  only  operated  on  at  the  age  of  from  six  months  to  a  year,  and 
as  a  rule  the  method  employed  is  that  of  bistournage. 

BISTOURNAGE. 

This  method  of  castration  has  been  practised  from  time  im- 
memorial. It  consists  essentially  of  torsion  of  the  testicular  cord, 
and  aims  at  obliterating  the  vessels  which  it  contains,  and  thus 
bringing  about  atrophy  of  the  organs  served  by  them. 

The  Bull. — The  animal  is  operated  on  in  the  standing  position. 
The  head  is  fixed  to  a  post  or  ring   somewhat  high  up,   in  order  to 


752 


GENITO-URINARY    ORGANS. 


Fig.  309.— Bistournage.     First  phase, 
the  scrotum. 


Manipulatinc 


check  movement  of  the  hind  legs.      The  hind  legs  are  also  partially 

secured  by  means  of 
ropes  or  two  pieces 
of  webbing  passed  in 
a  running  noose  about 
the  hocks  and  fixed 
above  the  knee.  No 
preliminary  disinfec- 
tion is  practised,  be- 
cause no  wound  is 
made. 

Manual  Technique. 
The  operation  com- 
prises four  stages  : 

First  stage.     The 
operator,  standing  be- 
hind  the  animal's  hocks,  grasps  the  testicular  cords  with  the  hands, 
immediately    above   the   testicles,   and    by  exercising    strong   pressure, 
thrusts    the   latter    to    the    extreme 
base   of    the   scrotum.      The   move- 
ment is  next   reversed ;    seizing  the 
base  of   the  scrotum  with  the  right 
hand,    he    draws   it    smartly    down- 
wards,   whilst    he    places    the    left 
hand  above   the   right,   and   thrusts 
the  testicles  towards  the  abdomen.  If 
the  testicles  do  not  rise  sufficiently 
high,    the     right    hand    is     slipped 
between    these   and    the    left   hand, 
and  the  testicles  are  thus  thrust  up- 
wards   towards    the    lower    inguinal 
rings,  slightly  dilating  the  latter. 

After  this  manipulation  has  been 
repeated  two  or  three  times,  the 
scrotum,  etc.,  become  more  pliable 
and  the  testicles  more  easily  dis- 
placed. The  second  stage  of  the 
operation  is  thus  facilitated. 

Second  stage.  The  second  stage 
of  operation  may  be  effected  by  one 
of  two  methods. 

Old  method:  The  oldest  method 
consists  in  allowing  one  of  the  testicles  to  rise  towards  th 


Fig.  310. — Bistournage.  First  phase. 
Thrusting  the  testicles  upwards; 
manipulating  the  scrotum. 

in^iuinal 


CASTRATION. 


753 


ring  and    to  tarn  the  other  in  a  vertical  plane.      If,  for  instance,  it 
is  desired  to  turn  the  right  testicle,  the  cord  is  grasped  between  the 


Fig.  811.— Bistournage.     Second  phase. 


thumb  and  index  linger  of  the  left  hand  (Fig.  311),  the  lower  part 
of  the  scrotum  is  seized  with  the  right  hand,  and  the  object  then 
is  to  slide  the  point  of   the  testicle  along  the  dorsal   surface  of   the 


754 


GENITO-URINARY    ORGANS. 


fingers  (Fig.  311).  Simultaneously  the  operator  presses  on  the  base 
of  the  testicle  with  the  thumb  of  the  left  hand,  thus  causing  a  rotary 
movement  in  a  vertical  plane ;  the  tail  of  the  epididymis  becomes 
uppermost.  A  certain  empty  space  separates  the  testicle  from  the 
base  of  the  scrotum. 

Third  stage.  Torsion  of  the  cord.  Tbe  testicle  having  been 
rotated,  the  cord  must  be  twisted  so  that  the  vessels  may  be  oblite- 
rated. The  left  hand  continues  grasping  the  cord,  which  is  then 
brought  in  front  of  the  testicle,  whilst  with  the  right  hand  the  testicle 
is  pushed  backwards  and  is  made  to  describe  a  semi-circle.  The  cord 
was  previously  on  the  left  side  ;  it  is  now  on  the  right,  and  simul- 
taneously the  testicle  passes  from  right  to  left. 

In  completing  the  turn  the 
hands  must  not  be  changed,  and, 
above  all,  must  not  let  go  their 
hold;  and  the  cord  is  pushed  for- 
wards and  towards  the  right  with 
the  right  hand,  whilst  the  testicle 
is  pushed  backwards  and  to  the 
left  with  the  left  hand.  The  cord 
and  the  testicle  resume  their  ori- 
ginal position ;  one  complete  turn 
has  been  effected.  These  manipu- 
lations are  repeated  several  times, 
and  the  cord  soon  assumes  the 
appearance  of  a  large,  hard,  tense 
string.  To  ensure  obliteration  seven 
or  eight  turns  should  be  made  in 
the  case  of  the  bull  and  four  or 
five  in  that  of  the  ram. 

Torsion  of  the  right  testicle 
being'  complete,  the  gland  is  thrust  towards  the  upper  part  of  the 
scrotum  and  the  left  testicle  is  submitted  to  the  same  manipulation, 
the  position  of  the  hands,  however,  being  reversed. 

Fourth  stage.  Fixation  of  the  testicles  in  the  inguinal  region. 
Both  testicles  having  been  thrust  upwards  as  far  as  possible  into 
the  inguinal  region,  the  scrotum  is  ligatured  below  them.  Tape  or 
thick  cord  should  be  used,  to  guard  against  gangrene  of  the  lower 
portions  of  the  scrotum.  A  considerable  oedematous  swelling  soon 
occurs,  and  when  at  the  end  of  twenty-four  or  forty-eight  hours 
infiltration  is  w'ell  developed,  the  ligature  should  be  removed. 

Dubourdieu  has  described  a  different  method,  in  which  the  testicle 
is    rotated    in    a    horizontal    plane.      The    position    of   the    hands  is 


Fig.  812. — Bistournage.     Third  phase. 


CASTRATION, 


75; 


Fig.  313. — Bistournage.     Second  phase. 
Dubourdieu's  method. 


then  different.  The  left  testicle,  for  instance,  being  at  the  base 
of  the  scrotum,  the  cord  is 
grasped  with  the  right  hand 
opposite  the  base  of  the  tes- 
ticle, and  the  tail  of  the  epi- 
didymis and  the  testicle  are 
held  with  the  whole  hand 
whilst  being  rotated.  If  care 
is  taken  to  fix  the  cord  with 
the  right  hand,  rotation  is 
more  rapid  and  easier  than 
in  the  preceding  method. 

DiflBculties  in  Operation. 
— Bistournage  is  highly  com- 
mended in  France  on  account 
of  its  avoiding  all  the  com- 
plications resulting  from 
sanguinary  operations.  Never- 
theless it  presents  great  diffi- 
culties, particularly  in  bulls  of 

from    two   to   three   years   of   age,  in  which  the   testicles   are  hard  to 
manipulate  on  account  of  their  size,  the  thickness  of   the  connective 

tissue,  and  sometimes  because 
X  of    abnormal     adhesions.      In 

such  cases  the  preliminary 
manipulation  alone  some- 
times extends  over  half  an 
hour. 

Bistournage  is  of  doubt- 
ful efficacy  when  the  testicles 
are  small  and  round,  because 
after  the  ligature  has  been 
applied  the  testicular  cord 
tends  to  untwist,  and  the 
shape  of  the  testicles  readily 
lends  itself  to  such  move- 
ments. If  untwisting  occurs, 
the  operation   fails. 

Consequences  of  the  Opera- 
tion.— The  operation   is    often 
followed  by   more  or  less  vio- 
lent    attacks     of    colic ;      the 
animal  may  suffer  for  five  or  six  hours,  after  which  it  recovers. 

3  c  2 


Fig.  314. — Bistournage.     Second  phase. 
Dubourdieu's  method. 


7o6  OENITO- URINARY    ORGANS. 

If  torsion  lias  been  clnmsily  performed,  or  if  the  ligature  be- 
comes displaced,  the  testicle  may  descend  and  the  cords  untwist ; 
the  latter  then  appear  to  have  lost  the  firm,  tense  consistence 
which  they  presented  after  operation.  To  prevent  slipping  of  the 
ligature  and  untwisting  of  the  cord,  Guiltard  suggests  the  use 
of  an  iron  needle,  with  which  the  scrotum  is  pierced  through 
the  median  line,  just  beneath  the  testicles  when  at  their  highest 
position ;  above  this  is  placed  the  ligature,  which  then  cannot 
possibly    slip. 

The  Basque  operators,  in  order  to  avoid  untwisting,  exercise 
vigorous  traction  from  above  downwards  after  rotating  the  testicle. 
In  this  way  ruptures  occur  which  diminish  the  elasticity  of  the 
cord  and  the  epididymis,  and  tend  to  check  the  untwisting  of  the 
former. 

When  the  operation  has  succeeded  the  testicles  gradually  atrophy. 
They  do  not  disappear  completely,  and  may  sometimes  be  found  several 
years  later  of  the  size  of  a  hazel-nut  or  a  chestnut  and  of  fibrous  con- 
sistence. It  need  scarcely  be  said  that  in  tlie  event  of  bistournage 
failing,  cutting  operations  can  always  be  resorted  to. 


MARTELAGE. 

The  process  of  martelage  consists  in  mutilating  with  a  mallet  the 
testicular  cord  whilst  still  covered  by  all  its  envelopes.  This  mutila- 
tion injures  the  walls  of  the  arteries,  causing  the  formation  of  a  clot, 
which  cuts  off  the  supply  of  Idood  to  the  testicle  and  causes  the 
gland  to  atrophy. 

The  practice  is  very  ancient. 

The  animal  is  fixed  by  the  horns  as  if  for  bistournage,  and 
the  limbs  are  secured  by  two  strips  of  webbing  or  two  ropes,  as 
in  the  former  case,  though  some  practitioners  neglect  the  latter 
precaution. 

Two  cylindrical  rods  the  size  of  broomsticks  and  a  wooden  mallet 
or  farrier's  hammer  are  the  instruments  employed. 

The  method,  however,  is  barbarous,  cruel,  and  of  doubtful  value. 
It  would  never  be  countenanced  in  England. 


CASTRATION    BY    CLAJIS. 

Castration  of  bulls  by  means  of  clams  has  been  practised  in  many 
different  forms. 


CASTRATION. 


757 


Castration  by  the  Exposed  Method.— The  operation  is  the  same 
as  in  the  horse,  the  scrotum  being  incised  on  either  side,  and  the 
dartos,  connective  tissue,  tunica  vaginahs  scroti,  and  tunica 
vaginahs  testis  being  divided.  Short  chims  are  apphed  to  the 
cord,  and  the  himen  of  the  arteries  is  completely  obhte- 
rated  in  five  to  six 
days,  when  the 
clams  can  be 
removed. 

Instead  of  an  in- 
cision being  made 
for  the  removal  of 
each  testicle,  the 
scrotum  and  dartos 
may  be  divided  in 
the  middle  line,  after 
which  incisions  may 
be  made  to  the  right 
and  left  respectively, 
exposing  the  fibrous 
tissue  and  enabling 
the  testicles  to  be 
enucleated.  A  clam 
may  then  be  applied 
to  each  cord,  or  the 
two  cords  may  be  in- 
cluded in  one  pair 
of  clams. 

This  method  has  the  advantage  of  inflicting  less  injury  on  the 
scrotum,  a  point  which  is  of  some  importance  in  animals  destined  for 
slaughter. 

Castration  by  the  Covered  Method.— This  operation  is  identical 
with  the  preceding,  except  that  the  incision  of  the  scrotum  does 
not  involve  the  cremaster  and  fibrous  tunic,  or  the  tunica  vaginalis 
scroti. 


Fig.  315. — Crushing  the  testicular  cord.     (This  uiethod 
is  to  be  strongly  condennied.) 


CASTRATION    BY    TORSION. 

The  cord  may  be  twisted  throughout  its  entire  length  or  torsion 
may  be  limited  to  a  part  of  the  cord,  hence  the  two  methods  here- 
after described. 

(a)  Limited  Torsion. — The  testicles  are  exposed  as  in  castration 
by  the   open   method.     The  cord   is  then  drawn  forward  and  fixed  by 


758 


GEXITO-URINATIV   ORGANS. 


means  of  forceps  applied  just  outside  the  scrotum  ;  f  to  1  inch  below 
this  point  the  torsion  forceps  are  applied.  The  cord  is  slowly 
twisted,  and  usually  ruptures  about  the  centre  of  the  fragment  in- 
cluded between  the  two  pairs  of  forceps. 

{h)  Direct  or  Unlimited  Torsion. — First  stage.  The  testicle  is  ex- 
posed, as  in  castration 
by  the  covered  method. 
Second  stage.  The 
cord  and  vaginal  tunic 
are  twisted  by  grasp- 
ing the  testicle,  which 
is  protected  with  a 
\  >]r  j# '  *i  Jt^'-^&f  1/      JM  piece  of  clean  linen. 


CASrRATION    WITH    THE 
ACTUAL    CAUTERY. 

The  testicles  are 
exposed,  the  cords  are 
seized  with  clams  and 
divided  separately  or 
together  with  a  sharp- 
bladed  cautery  at  a 
white  heat.  The  es- 
char so  produced  is 
sufticiently  dense  to 
obliterate  the  vessels. 

CASTRATION      BY      THE 
ELASTIC    LIGATURE. 

This  method  has 
been  largely  employed 
during  the  last  ten 
or  fifteen  years.  It 
consists  in  applying  to  the  upper  part  of  the  scrotum  several  turns 
of  a  tensely  stretched  round  or  square  rubber  thread.  The  two 
ends  of  the  rubber  thread  are  crossed  and  tied  with  string.  About 
the  seventh  or  eighth  day  the  testicles  may  be  removed  with  a 
knife  close  to  the  ligature,  provided  the  process  of  delimitation  is 
well  advanced. 

The  chief  objection  to  this  method  lies  in  the  fact  that  the 
scrotum  is  destroyed,  which  lowers  the  value  of  the  animal  from 
a  commercial  point  of  view. 


Fig.   816. — Castrati)ig  the  ram  by  ligature, 
method  is  to  be  strongly  condemned.) 


(This 


CASTRATION. 


759 


CASTRATION    OF    THE    RAM. 

Most  of  the  preceding  methods  may  be  used  in  castrating  rams, 
but  certain  s^jecial  methods  are  more  generahy  employed.  These  we 
shall  shortly  mention. 

Castration  by  Bistournage. — The  method  is  exactly  similar  to  that 
in  the  bull.  The  animals  are  placed  in  the  position  shown  in  the 
figure,  except  that  the  hind  limbs  are  extended  and  held  in  that 
position  b}'  the  operator's  knees  or  feet.  The  process  is  onl}^  applic- 
able to  animals  of  four  or  five  months  old. 

Castration  by  Tearing. — This  method  is  only  practised  by  shep- 
herds, and  on  animals  a  few  days  or  at  most  a  month  old.  The 
base    of    the    scrotum    is    snipped    oft"    with  scissors,  the   testicles   are 


Fig.  317. — Castration  of  young  pigs. 

enucleated,  and  each  in  turn  is  seized  and  torn  away  with  a  sudden 
snatch.  Even  though  a  considerable,  length  of  cord  is  removed  with 
the  testicle,  bad  results  seldom  follow,  provided  the  subject  is  not 
of  greater  age  than  that  mentioned. 

Castration  by  Ligature. — This  method  consists  in  passing  a  stout 
ligature  in  the  form  of  a  running  knot  over  the  neck  of  the  scrotum 
and,  by  means  of  two  short  pieces  of  wood,  drawing  it  tight.  The 
method,  however,  is  not  to  be  recommended,  as  it  not  infrequently 
leads  to  tetanus. 


CASTRATION    OF    BOARS    AND    YOUNG    PIGS. 

For  castration  boars  should  be  cast  on  the  left  side,  and  three 
legs  at  least  firmly  secured  together  (Fig.  317).  The  best  method  is 
that  of  limited  torsion.     Care  should  be  taken  to  avoid  dragging  the 


760  GENITO-T^lMNARY    ORGANS, 

cord  downwards  during  the  operation,  for  the  testicular  artery  rup- 
tures readily,  and  fatal  abdominal  hfemorrhage  may  follow. 

As  the  subjects  are  apt  to  wallow  in  the  litter  after  the  opera- 
tion a  strip  of  iodoform  gauze  should  be  applied  and  secured  by 
one  or  two  sutures.     This  is  removed  on  the  third  or  fourth  day. 

On  young  pigs  the  operation  is  simpler.  The  animal  is  cast  on 
the  left  side  and  firmly  held,  the  left  hind  limb  being  extended  and 
the  right  drawn  towards  the  right  shoulder. 

The  testicles  are  grasped  each  in  turn  with  the  left  hand,  whilst 
with  the  right  they  are  exposed  by  a  single  sweep  of  the  bistoury. 
The  testicles  are  removed  by  torsion  with  artery  forceps.  Many  lay- 
men simply  use  the  hands,  the  cord  being  grasped  between  the  left 
thumb  and  index  finger,  whilst  torsion  is  effected  by  the  right  index 
finger  thrust  between  the  vas  deferens  and  the  body  of  the  testicle. 

CASTRATION  OF  CRYPTORCHIDS. 

Cryptorchids  are  very  rare  amongst  cattle  and  sheep,  as  the 
testicles  enter  the  scrotum  during  intra-uterine  life.  The  internal 
inguinal  ring  in  the  pig  being  of  very  small  size,  the  condition 
is  more  common  in  that  animal. 

The  same  process  is  employed  in  castrating  cryptorchid  bulls, 
rams,  or  boars.  The  animal  is  thrown  on  one  side  and  securely 
fixed.  A  vertical  incision  is  made  in  the  region  of  the  flank,  vary- 
ing in  length  from  4  to  5  inches  in  the  bull,  '2  to  2^  inches  in 
the  ram,  and  4  to  5  inches  in  the  pig.  The  abdominal  cavity  is 
examined,  the  testicle  found,  and  a  ligature  applied  to  the  cord,  after 
which  the  testicle  is  removed. 

Another  method  consists  in  employing  the  ecraseur  for  division 
of  the  cord. 

To  avoid  subsequent  complications  antiseptic  precautions  should  be 
taken. 

Complications  after  Castration. — Whatever  the  method  employed, 
swelling  of  a  more  or  less  abundant  character  always  develops  during 
the  few  days  immediately  succeeding  the  operation.  It  is,  however, 
of  little  importance. 

Should  antiseptic  precautions  be  neglected,  suppuration,  septi- 
caemia, tetanus,  and  sometimes  scirrhous  cord  may  follow.] 

FEMALE    GENITAL    ORGANS. 

Examination  with  the  Speculum. — In  the  cow  certain  diseases 
of  the  vagina,  bladder,  neck  of  the  uterus,  and  even  of  the  uterus 
itself,  may  necessitate  visual  examination  in  addition  to   the  manual 


CASTRATION. 


^()1 


examination  commonly  employed.  Under  such  circumstances  a  special 
speculum  is  introduced  in  a  closed  condition,  being  afterwards  opened 
and  dilated  to  the  required  extent. 

Before  inserting  the  speculum,  however,  the  genital  passages  should 
be  cleaned,  and  the  speculum  itself  smeared  with  vaseline.  It  pene- 
trates readily  with  moderate  pressure. 

Heifers  and  similar  animals  require  a  special  (small)  instrument 
(Fig.  318). 

In  certain  circumstances,  moreover,  it  is  preferable  to  use  retractors, 
with  which  local  examination  is  easier.     These  can  be  applied  at  either 
side  of  the  vagina  and  drawn  apart,  thus  ex- 
posing the  depths  of  the  genital  tract. 


CASTRATION    OF    THE    COW. 

The  operation  of  castrating  the  cow  is 
very  old,  and  was  mentioned  by  both  Aristotle 
and  Pliny.  Many  other  descriptions  of  it 
have  since  been  given.  But  more  recently 
the  manual  technique  has  been  considerably 
simplified  and  very  fully  described. 

Utility. — The  operation  is  practised  for 
the  cure  of  nympho-mania  ;  also  to  prolong 
the  period  of  milk-yielding  and  to  facihtate 
fattening. 

As  regards  nympho-mania,  it  is  only  of 
value  where  the  excessive  excitement  is  due 
to  disease  of  the  ovaries. 

Under  ordinary  conditions  the  secretion  of 
milk  diminishes  more  or  less,  and  becomes 
very  slight  after  eight  or  nine  months  from 
calving.  If,  however,  the  cow  is  castrated 
under  favourable  circumstances,  lactation  con- 
tinues for  several  months,  sometimes  for  several  years,  beyond  this 
period.  It  is  said  that  castrated  cows  yield  milk  of  a  more  constant 
composition  and  richer  in  butter  fat,  casein,  and  mineral  salts  than 
those  which  are  not  castrated,  although  the  point  cannot  be  said  to  have 
been  fully  established. 

To  obtain  the  best  results  the  subjects  should  have  attained  their 
maximum  yield  of  milk  and  be  from  five  to  seven  years  old.  The  best 
period  is  six  weeks  to  two  and  a  half  months  after  calving.  Neglect  of 
these  considerations  is  liable  to  be  followed  by  inappreciable,  doubtful, 
or  bad  results. 


Fig.  318. — Vaginal  speculum 
for  heifers. 


762  UENIT0-T4{1NARV   ORGANM, 

The  influence  of  castration  on  fattening  is  explained  ])y  the  suppres- 
sion of  oestrum. 

Manual  Technique. — An  ovariotome  with  a  hidden  blade  and  an 
ecmsctir  with  an  extra  long  stem  are  the  only  instruments  required. 
The  animals  should  be  prepared  for  some  days  by  diminishing  their 
food  supi^ly  and  administering  gentle  laxatives. 

Acute  or  chronic  lesions  of  the  genital  tract  should  be  held  to 
contra-indicate  operation,  and  it  should  be  noted  that  tuberculous 
animals  are  particularly  liable  to  awkward  complications. 

On  the  day  of  operation  an  abundant  enema  is  given,  to  empty  the 
rectum,  after  which  the  vagina  is  washed  out  freely  with  a  lukewarm 
solution  of  some  non-irritant  antiseptic.  The  hind  quarters,  and  par- 
ticularly the  neighbourhood  of  the  anus,  vulva,  base  of  the  tail,  etc., 
should  be  carefully  washed  and  disinfected  with  a  solution  of  lysol, 
cresyl  or  carbolic  acid. 

The  patients  are  secured  in  a  standing  position,  a  rope  being 
passed  in  the  form  of  the  figure  8  around  the  hind  limbs  above  the 


Fig.  319. — Ovariotome. 

hocks,  and  the  animal  is  then  firmly  thrust  against  a  wall  by  several 
strong  assistants. 

The  operator's  hands  and  instruments  must  be  rigorously  disinfected. 

The  operation  comprises  three  stages  : 

First  stage.     Puncture  of  the  vagina. 

Second  stage.     Finding  and  securing  the  ovaries. 

Third  stage.     Ablation. 

The  hand  is  smeared  with  sterilised  oil,  and,  grasping  the  ovario- 
tome, is  passed  into  the  vagina,  which  contracts  on  it  and  on  the  fore- 
arm. Within  a  short  time,  however,  which  may  vary  between  tw'O  or 
three  minutes  and  a  quarter  of  an  hour,  the  vagina  becomes  distended 
and  its  walls  rigid,  so  that  the  operator  is  able  to  continue  his  manipu- 
lations more  easily.  'J'his  is  the  moment  for  effecting  puncture,  after 
an  examination  of  the  pelvic  organs  through  the  vaginal  walls. 

The  blade  of  the  ovariotome  is  advanced  until  fully  exposed,  and  the 
point  is  brought  directly  above  the  neck  of  the  uterus,  about  f  to  l.[ 
inches  from  it.  By  a  sharp  movement  the  instrument  is  then  thrust 
directly  forw^ard,   dividing  the  wall  of  the  vagina   in  the   median   line. 


CASTRATION. 


763 


The  blade  is  next  retracted  into  its  sheath  and  the  instrument 
dropped  on  to  the  floor  of  the  vagina.  The  right  index  finger  is  at  once 
passed  through  the  orifice  so  made  into  the  peritoneal  cavity,  in  order 
to  make  certain  that  all  the  membranes  have  been  divided.  By  pressing 
on  and  slightly  tearing  the  tissues  the  middle  finger  is  then  introduced 
alongside  the  index.  Only  these  two  fingers  should  be  passed  into  the 
peritoneal  cavity. 

In  order  to  secure  the  ovaries  it  then  suffices  (Fig.  321)  to  thrust 
forward  the  base  of 
the  vagina,  allowing 
the  two  fingers  to 
glide  over  the  body 
of  the  uterus  and 
thence  downward 
over  its  side  to  the 
point  where  the 
horns  of  the  uterus 
originate.  Here  the 
fingers  meet  the 
ovary,which  is  readily 
recognisable  on  ac- 
count of  its  size  and 
shape  (those  of  a 
walnut).  The  gland 
is  nipped  between  the 
index  and  middle 
fingers,  and  is  drawn 
into  the  vagina 
through  the  opera- 
tive opening. 

In  order  to  re- 
move the  ovary  the 
operator  seizes  the 
('erase  II  r     with     the 

left  hand,  a  loop  of  chain  about  an  inch  long  projecting,  and  slides 
the  instrument  along  his  right  forearm.  The  arm  must  be  retained 
in  the  vagina,  the  fingers  grasping  the  ovary.  The  organ  is  slipped 
into  the  loop  of  the  ecraseur,  which  is  then  manipulated  with  the  left 
hand  until  the  pedicle  is  divided.  To  prevent  haBuiorrhage  the  screw 
of  the  cerascnr  should  only  be  turned  at  the  rate  of  about  twice  a 
minute.  The  ovary  when  separated  is  left  on  the  floor  of  the  vagina, 
the  fingers  being  again  introduced  into  the  abdominal  cavity  to  secure 
the  second  one.     This  is  removed  in  precisely  the  same  way. 


Fig.  320.— Castration  of  the  cow.     First  phase. 


7()4. 


GENITO-UllINARY    OR<iANS. 


The  pedicles  of  the  ovaries  are  released,  and  at  once  return  to  the 
peritoneal  cavity,  while  the  operator,  in  withdrawing  his  hand,  brings 
with  it  the  knife  and  the  ovaries  themselves.  The  lips  of  the  operative 
incision  come  together  again  spontaneouslv  as  tlie  vagina  contracts. 

This  operation  is  followed  by  slight  colic,  which,  however,  need  not 
cause  alarm. 

Complications :  Haemorrhage. — If  the  incision  is  unskilfully  per- 
formed, it  may  in   exceptional  cases  result   in   injury  of  the  terminal 

portion  of  the  aorta  or 


the  iliac  arteries.  The 
blood  then  streams 
past  the  operator's 
hand,  and  the  animal 
dies  of  internal 
haemorrhage  in  a  few 
minutes;  nothing  can 
be  done. 

If  there  is  undue 
haste  in  manipulating 
the  i'c raseitr,  the 
pedicle  of  the  ovary 
is  cut  rather  than 
crushed,  the  vessels 
close  imperfectly,  and 
grave  haemorrhage 
may  occur. 

In  cases  where 
luismorrhage  is  slight 
the  peritoneal  clot  is 
readily  re  -  absorbed  ; 
but  should  the  animal 
happen  to  be  tuber- 
culous or  its  vessels 
hnemorrhage    may   occur   and   may 


Fig.  321. — Castration  of  the  cow.     Second  phase. 


in    any   other    way   diseased,    fri 
eventually  be  foUow'ed  by  fatal  peritonitis. 

Hernia  of  the  intestine  through  the  vagina  is  a  rare  complication 
nowadays,  on  account  of  the  small  dimensions  of  the  perforations. 
In  former  times,  when  larger  incisions  were  made,  it  occurred  rather 
frequently. 

Abscess  Formation. — Suppuration  of  the  wound  and  peritonitis  or 
vaginitis  are  caused    solely  by   the  neglect   of   antiseptic   precautions. 

Pelvic  peritonitis  following  an  operation  is  indicated,  like  ordinary 
acute  peritonitis,  by  loss  of  appetite,  peritonism,  colic,  etc. 


CASTRATION.  765 

Even  where  peritonitis  is  avoided  a  local  abscess  often  forms  in 
the  vaginal  wall  owing  to  infection  of  the  operation  wound.  The 
symptoms  are  delayed  for  several  days,  sometimes  for  a  fortnight 
after  operation,  and  consist  in  straining  efforts,  moderate  peritonism, 
diminution  in  appetite,  etc.  Vaginal  or  rectal  examination  reveals 
the  character  and  extent  of  the  disease.  The  abscess  should  be 
punctured  through  the  vagina. 

Finally,  it  may  happen  that  castration  does  not  prevent  the 
recurrence  of  oestrum.  The  ovarian  pedicle  may  have  been  divided 
too  close  to  the  glandular  tissue,  a  fragment  of  which  has  remained 
adherent  to  the  pedicle. 

Certain  other  operative  complications  are  also  possible  in  dealing 
with  cows  suffering  from  nympho-mania  which  have  developed  cysts, 
tumours,  or  abscesses  of  the  ovaries.  It  is  then  necessary  to  enlarge 
the  incision  in  the  vagina  and  take  particular  precautions  not  to 
rupture  the  cysts  or  abscesses  in  the  peritoneal  cavity.  The  operator 
must  proceed  cautiously  and  modify  his  technique  according  to  cir- 
cumstances. 

CASTRATION    OF    THE    SOW. 

Castration  of  the  sow  has  been  practised  since  very  ancient 
times.  The  operation  is  performed  on  animals  intended  for  fatten- 
ing, and  at  all  ages  between  six  weeks  and  maturity. 

Anatomical  Arrangement  of  the  Genital  Organs. — Before  perform- 
ing ovariotomy  in  the  sow  it  is  indispensable  to  understand  the  special 
arrangement  of  the  genital  organs.  The  uterine  horns  are  very  long 
and  folded  on  themselves,  forming  convolutions  which  give  them 
somewhat  the  appearance  of  small  loops  of  intestine.  Nevertheless 
they  can  readily  be  distinguished  by  the  touch,  for  they  are  much 
smaller  in  size  than  the  latter. 

In  young  sows,  two  to  three  months  old,  they  are  of  about  the 
thickness  of  a  small  ]iencil.  Differentiation  is  more  difffcult  in 
sows  that  have  borne  litters,  but  as  the  ovaries  alone  are  withdrawn, 
leaving  the  horns  of  the  uterus  uninjured,  this  distinction  is  unim- 
portant. 

The  horns  of  the  uterus  are  suspended  in  the  peritoneal  cavity 
by  means  of  very  extensive,  well-developed,  and  very  lax  ligaments, 
and,  as  the  horns  of  the  uterus  lie  at  a  very  acute  angle  one  to  the 
other,  the  ovaries  are  very  close  to  the  median  line  of  the  abdo- 
men. The  length  and  yielding  character  of  the  parts  and  the  close 
apposition  of  the  ovaries  explain  why  the  latter  can  l)e  found  and  ex- 
tracted through  a  single  incision  in  the  flank,  either  on  the  right  or 
left  side. 


766  GENITO-URINARY   ORGANS. 

An  ordinary  convex  bistoury  or  a  special  knife  and  two  artery 
forceps  are  the  instruments  emploj'ed. 

Manual  Technique. — The  animal  is  cast  on  the  right  or  left  side, 
preferably  on  the  right,  so  that  the  right  index  finger  can  be  employed. 
Full-grown  sows  should  always  be  muzzled.  In  the  case  of  young 
animals,  the  limbs  should  be  grasped  by  assistants,  the  hind  limbs 
being  crossed  one  over  the  other  and  drawn  backwards. 

Antiseptic  applications  are  highly  desirable,  although  they  are 
usually  neglected  when  a  layman  directs  the  operation. 

The  operator  places  himself  close  to  the  animal's  back.  The  in- 
cision may  be  made  in  one  of  three  different  places. 

Certain   practitioners   recommend    a   vertical   incision    about    2   to 


\\\^^ 


Fig.  322. — Genital  organs  of  the  sow.     1,  Ovary  ;    2,  liorn  of  the  uterus 
3,  uterus  ;  4,  rectum  ;  5,  vagina  ;  6,  bladder  ;  7,  kidney  ;  9,  intestine. 


2|  inches  in  length,  commencing  at  the  external  angle  of  the  ilium, 
or  ^  of  an  inch  in  front  of  it,  and  prolonged  downwards;  others 
make  a  horizontal  incision  parallel  with  the  vertebral  axis ;  and, 
lastly,  some  believe  that  an  oblique  incision  following  the  direction 
of  the  "cord  of  the  flank"  is  just  as  advantageous.  A  vertical  or 
oblique  incision  is  probably  the  best. 

The  operation  comprises  four  stages  : 

First  stage.     Incision  of  the  skin  and  subjacent  muscles. 

Second  stage.  Perforation  of  the  peritoneum  and  discovery  of  the 
ovaries. 


CASTRATION. 


767 


Third  stage.  Ablation  of  the  ovaries  or  of  the  ovaries  and  horns 
of  the  uterus. 

Fourth  stage.     Suture  of  the  wound. 

The  tissues  are  divided  layer  by  layer.  The  skin  is  formed  into 
a  longitudinal  fold  and  divided  in  a  vertical  direction,  and  the  sub- 
jacent muscular  layers  are  then  divided  with  the  bistoury.  The 
tissues  are  next  broken  through  layer  by  layer  with  the  index  finger 
until  the  parietal  peritoneum  is  reached.  This  membrane  is  then 
fissured,  or  at  least  scraped  with  the  nail,  and  perforated  wdth  a 
sudden  sharp  thrust  of   the  index  finger. 

This  practice,  however,  has  the  disadvantage  of  sometimes  causing 
the  parietal  peritoneum  to  strip  away  from  the  wall  of  the  abdomen, 
which  greatly  increases  the  difficulties  of  opera- 
tion. It  is  better,  therefore,  to  grasp  the  peri- 
toneum wdth  a  small  pair  of  forceps,  draw  it  out- 
wards, and  secure  it  so  as  to  puncture  it  with 
more  certainty.  When  experience  has  been  ac- 
quired this  precaution  will  be  unnecessary. 

The  incision  being  made  and  the  finger  in- 
troduced into  the  abdomen,  the  operator,  who 
kneels  against  the  animal's  back,  searches  for 
the  ovaries  with  his  index  finger.  The  upper 
ovary  of  the  side  in  which  the  incision  has  been 
made  will  be  found  immediately  in  contact  with 
the  parietal  peritoneum,  and  the  operator  must 
take  care  not  to  displace  it  by  untimely  or  care- 
less manipulation,  which  may  thrust  it  away 
among  the  loops  of  intestine.  The  finger  being 
doubled  up  in  the  form  of  a  hook,  the  ovary  is 
seized  and  drawn    out.      Sometimes   it   may   be 

easier  to  withdraw  the  uterine  horn,  leaving  the  search  for  the  ovary 
until  a  little  later. 

The  first  ovary  having  been  discovered,  its  pedicle  is  seized 
between  the  left_  thumb  and  index  finger  or  the  jaws  of  pressure 
forceps,  and  then  the  search  is  continued  for  that  of  the  opposite 
side.  In  young  sows  the  horn  of  the  uterus  may  be  followed  up 
from  its  extremity  (ovarian  extremity)  towards  its  origin  (bifurcation 
of  the  body  of  the  uterus)  and  the  search  continued  along  the  horn 
of  the  uterus  of  the  opposite  side,  which  is  followed  in  the  reverse 
direction  from  its  base  towards  its  extremity  until  the  second  ovary 
is  found. 

The  most  difficult  stage  is  that  at  which  the  change  is  made  from 
one  horn  to  the  other,  for  this  is   the  moment  when  the  contraction 


Fig.  323 — Castrating 
knives. 


7<l8  GENITO-URIXAKY    ORGANS. 

of  the  parts  is  most  violent,  the  animal's  struggles  most  energetic 
and  the  pain  most  acute,  so  that  great  care  must  be  taken  not  to 
let  go  the  horn  which  has  already  been  secured. 

When  tlie  second  ovary  appears  at  the  external  orifice,  it  is  secured 
like  the  preceding,  and  both  are  removed  by  torsion.  The  horns  of 
the  uterus  are  then  freed  and  returned  to  the  abdominal  cavity,  the 
wound  is  thoroughly  disinfected  and  united  with  from  one  to  three 
interrupted  sutures  passed  through  the  skin.  The  animal  is  then 
allowed  to  rise.     Complications  are  rare. 

In  small  females  the  uterine  horns  are  often  removed  by  tor- 
sion along  with  the  ovaries.  In  adults,  only  the  ovaries  are 
removed. 

Subsequent  Precautions:  OperatiYe  Accidents. — The  patients  are 
kept  on  low  diet  for  some  days  after  operation.  Accidental  stripping 
away  of  the  peritoneum  at  the  seat  of  operation  may  sometimes 
result  in  the  formation  of  a  little  abscess  when  the  wound  has  been 
infected.  This  is  diagnosed  by  direct  examination  or  palpation.  The 
lips  of  the  wound  are  then  opened  in  order  to  permit  the  pus  to 
escape  and  avoid  peritonitis.  Should  the  horns  of  the  uterus  or  the 
broad  ligaments  be  roughly  manipulated,  they  may  be  torn  to  some 
extent,  but  this  rarely  causes  grave  complications. 

Bleeding  from  the  incision  in  the  abdominal  wall  is  of  little 
importance. 

Hernia  rarely  occurs,  for  the  opening  in  the  peritoneum  is  of 
very   small    size. 

In  rare  cases,  and  when  care  is  not  used,  a  portion  of  the  intestine 
may  be  sutured  to  the  margin  of  the  wound.  The  intestine  then 
becomes  adherent  to .  the  abdominal  wall,  but  grave  results  seldom 
follow. 

SUTURE    OF    THE    VULVA 

In  cases  of  recurrence  after  reduction  of  an  inversion  of  the 
uterus  or  the  vagina  it  may  become  necessary  to  suture  the  vulva 
in   order   to   control    the   effects   of   straining. 

Several  forms  of  suture  are  emploj^ed ;  the  best  are  probably 
those   of   Rainard   and    Strebel. 

Simple  Suture. — Simple  suture  may  be  formed  of  very  flexible 
copper  wires.  Three  are  usually  inserted,  one  at  the  base,  one  about 
the  middle,  and  one  near  the  upper  third  of  the  vulval  opening. 
The  ends  of  each  suture  are  knotted  and  drawn  moderately  tight  over 
the  opening,  then  one  of  the  ends  of  the  highest  knot  is  united  verti- 
cally to  an  end  of  the  middle  knot,  and  the  latter  in  its  turn  is  simi- 
larly secured  to  the  lowest  knot. 


SUTURE    OF    THE    VULVA. 


7G9 


To  be  reliable,  sutures  sbould  embrace  the  entire  thickness  of  the 
lips  of  the  vulva. 

Rainard's  Suture. — -Rainard's  suture  consists  only  of  two  oblique 
stitches,  crossed  in  the  form  of  the  letter  "X,"  starting  from  the  upper 
third  of  one  of  the  lips  of  the  vulva  and  terminating  in  the  lower 
third  of  the  opposite  lip.  The  ends  are  tied  opposite  the  centre  of 
the  vulval  opening. 

Strebel's  Suture. — Strebel's  suture  consists  of  three  stitches  inserted 
transversely.  The  material  employed  is  galvanised  wire,  sharpened 
at   one   end    and   rolled   into    a   flat  spiral  a't  the  other.     Each  wire, 


Fig.  324. 

which  plays  the  part  of  a  needle,  is  inserted  separately,  and  is  after- 
wards twisted  mto  a  spiral  by  means  of  special  forceps,  the  excess  of 
length  being  thus  taken  up  until  the  lips  of  the  vulva  are  brought 
closely  in  contact. 

In  practice,  in  order  to  avoid  the  cutting  and  irritant  effect  of 
such  sutures  and  to  increase  their  efficiency,  two  rectangular  pieces 
of  leather  are  applied  on  either  side  through  holes  in  which  the 
actual  metallic  sutures  are  passed.  West's  vulval  clamp  is  better 
than  sutures.     It  is  very  popular  in  England 

TRUSSES. 
Trusses   applied   for   the   purpose   of   preventing   prolapsus   of   the 
genital   organs    are   now  almost   entirely  given    up,  as  they  very  im- 
perfectly achieve  their  object. 

D.c.  3  D 


770  GENITO-URINARY    ORGANS. 

Lund's  truss,  shown  in  the  illustration  (Fig.  325),  is  perhaps  the 
most  efficient  of  those  which  survive.  The  essential  portion  of  this 
is  of  metal,  and  is  approximately  of  the  shape  of  the  letter  "  V." 
The  two  ends  may  be  separated  and  drawn  together  at  will  by  means 
of   a   cord.       This   apparatus   is   held    in    contact    with    the   vulva    by 


h'lG.  325. — Lund's  truss. 

means  of  strings  which  pass  through  eyes  in  the  metallic  triangle 
and  are  secured  to  a  collar  placed  on  the  neck  or  to  a  girth  secured 
round  the  chest. 

SECTION    OF    THE    SPHINCTER    OF    THE    TEAT. 

This  oi^eration  is  performed  to  render  easily  pervious  the  ends  of 
teats  which  have  undergone  contraction  as  a  consequence  of  changes 
in  the  sphincter  or  from  some  other  cause. 

The  animals  are  secured,  and  the  teat  to  be  operated  on  having 
been  grasped  between  the  index  finger  and  thumb  of  the  left  hand, 
the  point  of  the  little  cutting  instrument  shown  in  Fig.  326  is  intro- 
duced into  the  opening  of  the  teat,  and  it  is  then  thrust  in  as  far 
as  the  shoulder  on  the  cutting  edges. 

DILATATION    OF    THE    ORIFICE    OF    THE    TEAT. 

The  results  of  the  above  operation  not  always  proving  permanent, 
and    cicatricial    contraction    often    following   after   a   few    weeks'    time, 


ABLATION    OF   THE    MAMMtE. 


771 


forced  dilatation  by  means  of  the  conical  tubes  shown  (Fig.  327)  has 
been  generally  substituted  for  it.  Three  instruments  of  varying  thick- 
ness are  usually  sufticient.  Forced  dilatation  may  be  effected  at  a 
single  operation,  and  has  not  the  drawback  of  causing  cicatrices. 


1    i 

m 


Fig.  o26. 


Fia.  327. 


ABLATION    OF    THE    MAMMAE. 

Ablation  of  the  mammee  is  rather  frequently  necessary,  principally 
in  cases  of  gangrenous  mammitis,  of  prolonged,  continuous  suppura- 
tion, or  of  grave  mammitis,  where  death  would  otherwise  follow. 

Provided  the  anatomical  structure  of  the  parts  is  known  (Fig.  237) 
ablation  does  not  present  any  insuperable  difficulty. 

In  the  cow,  either  two  lateral  quarters  or  the  entire  udder  must 
be  removed.  The  lines  of  incision  through  the  skin  should  first  of 
all   be   traced. 

One  half  of  the  udder  may  be  removed  by  the  following  method : 

First  stage.  Elliptical  incision  through  the  skin,  including  the 
two   teats   of   one    side. 

The  lines  of  incision  should  extend  backwards  sufficiently  high. to 
enable  the  vessels  at  the  base  of  the  gland  to  be  easily  ligatured. 

Second  stage.  Dissection  and  breaking  down  of  the  subcutaneous 
and  intermammary  connective  tissue.  The  anterior  mammary  vein 
must  be  ligatured. 

Third  stage.  Isolation  of  the  mamma  from  the  front  backwards, 
and  ligature  of  the  vessels  of  supply.     Extirpation. 

3  D  2 


72 


GENITO-UKINAHY    OK(3iANS. 


Fourth  stage.      Suture  and  drainage  of  the  operative  wound  with 
iodoform  gauze. 

This  operation  appears  to  cause  formidable  injuries,  the  abdominal 


Fig.  328  —Ablation  of  the  udder  in  the  cow.     Li,  Line  of  incision 
Ljj,  prolongation  backwards. 


Fig.  329.- -Ablation   of  the  udder  in  the  goat.     Li,   Line  of 
incision  ;  hj},  prolongation  backwards. 

tunic  and  the  muscles  of  the  flat  portion  of  the  thigh  being  largely  ex- 
posed, but  in  reality  the  wound  is  less  grave  than  might  be  supposed, 


Ablation  op  the  mamm^.  773 

and  healing  occurs  in  a  comparatively  short  time,  provided  none  of 
the  diseased  tissue  is  left. 

The  dressing  is  renewed  at  intervals  of  two  or  three  days,  and 
when  cicatrisation  proceeds  regularly  it  may  be  omitted  and  re- 
placed  by   antiseptic    irrigation. 

In  the  ewe  and  she-goat  the  operative  technique  is  identical  : 

First  stage.     Elliptical  incision,  including  the  teat. 

Second  stage.  Breaking  through  of  the  intermammary  connective 
tissue  partition  and  the  subcutaneous  tissue.  Ligature  of  the  anterior 
mammary  vein. 

Third  stage.  Isolation  of  the  mamma  from  the  front  back  wards. 
Ligature  of  the  vessels  of  supply.     Extirpation. 

Fourth  stage.     Suture  and  drainage. 


INDEX 


the 


Abdominal,  cavity,  diseases  of 
Ablation  of  the  mammaj 
Abomasal  iudigestiou 
Abomasum      .... 
,,  hernia  of  the 

,,  obstruction  of  the 

„  strongylosis  of. 

Abortion,  epizootic,  in  cows  . 
Acariasis,  non-psoroptic  forms  of 
Accessory  glands  of  the  genital  apparatus 
Accidental  phlebitis 
Acid  theory  in  diseases  of  bones 
Acids,  caustic,  poisoning  by  . 
Acne  in  the  sheep  . 
Acorns,  poisoning  by 
Acquired  hernias     . 
Actinomycosis 

Actual  cautery,  castration  with  tlie 
Acute  cystitis 

„       deep-seated  glossitis 

,,       eczema 

„       enteritis 

„       gastric  indigestion  in  swine 

„       gastritis        .... 

.,       inflammation  of  the  gastric 
partments 

„       laryngitis      .... 

,,       mammitis     .... 

,,       metritis        .... 

,,       nephritis       .... 

.,       parotiditis    ... 

,.       peritonitis    ... 

,,       jileurisy        ... 

,,       tuberculosis.         .         .      ■ 

„  vaginitis  ... 
^sculaceae  .... 
Agalaxia         ..... 

Agaricacea3 

Alkalies,  caustic,  poisoning  by 
Aloes,  poisoning  by 
Alsinace^       .... 
Ambrosiacea3 .... 
Amputation  of  the  claw 
Anaemia  in  cattle  . 
„  lambs  . 

,,  sheep   . 

Anesthesia     .... 
Annual  mercury,  poisoning  by 
Anomalies,  physiological 
Anus       ..... 

,,     imperforate    . 


PAGE 

478 
771 
1S2 
114 
498 
194 
2  (is 
5.-.8 
645 

89 1; 
8 
217 
606 
228 
489 
672 

511 
181 
599 
208 
1S5 
188 

186 
833 
573 
550 
528 
184 
478 
861 
704 
544 
246 
587 
225 
217 
221 
229 
256 
730 
268 
268 
268 
726 
256 
567 
116 
742 


Apiaceaj 

ApocynacCce   .         .         .         .         . 

Apparatus  of  locomotion 

.4  riif/f/Uui)  spicati/g,  poisoning  by  . 

Arsenic,  poisoning  by     . 

Arsenical  dips         .... 

Arteries,  examination  of 

"  Arthi'itis  of  milch  cows  "' 

Articular  rheumatism     . 

„  ,,  causes 

„  „  com[)licatioii 

Articulations,  diseases  of 

Ascites    ...... 

Asclepiadaceaj         .... 

Aspergilli,  pneumo-mycosis  due  to 


AGE 

247 

251 

730 

237 

218 

682 

371 

99 

89 

89 

91 

45 

488 

252 

8.50 


Barberry  family .... 

235 

Beech  family 

228 

Beef  measles 

79 

„          „        cause 

79 

„          ,,        symptoms 

81 

„          „        where  prevalent 

79 

Bell-flower  family  .... 

255 

Berberidacea3          .... 

';?35 

Biceps  femoris         .... 

70 

Bile  ducts,  cancer  of       .         .         . 

282 

Bilharziosis  in  cattle  and  sheep      . 

439 

Bistournage    ..... 

751 

Bitter  milk 

591 

Bladiler,  diseases  of  tiie  . 

511 

.,         eversion  of  the 

519 

paralysis  of  the 

•    519 

Bleeding 

727 

,,         in  the  pig         .         .         . 

728 

„         in  sheep  .... 

727 

Blood,  diseases  of  the     . 

406 

examination  of   . 

372 

„       poisoning  in  sheep  and  lambs  in 

New  Zealand  . 

415 

.,       -vessels,  diseases  of      . 

89ti 

Blood-wort  family  .... 

228 

Bloodv  flux  in  calves  and  lambs     . 

271 

Blue  milk 

590 

Boars,  castration  of         .         .         . 

759 

Bog  spavin  in  the  ox      . 

46 

Bone,  actinomycosis  of  . 

681 

„      tumours        .... 

30 

Bones  and  articulations,  tuberculosis  ol 

the 

701 

77G 


INi3EX4 


PAGE 

t 

AGE 

Bones,  diseases  of  . 

3 

Castration  by  the  exposed  meth 

xl 

757 

„              ,,           acid  theory 

3 

,.            .,   torsion      . 

757 

„              „           inflammation  th 

;ory .         4 

„          of  boars  and  young  pigs 

759 

„              ,,           theory  of  insnffic 

ency         8 

„           „  the  bull  and  ram 

751 

Bovine  animals,  calculi  in      . 

.     515 

„           „     .,    cow     . 

761 

piroplasniosis 

.     41<; 

„           „  cryptorchids 

760 

Box  family 

.     24G 

„           „  the  ram     . 

759 

Brain,  tuberculosis  of  the 

.     702 

11           11     11       i>    Ijy  l)istou 

nage    . 

759 

Braxy     

.     435 

11           11     11       11     11    ligatui 

e  . 

759 

Bronchi  

.     833 

,,           „     ,,       „     „   tearin_ 

r 

759 

Bronchitis 

.     336 

11           11     11    sow 

765 

„          chronic .         .         .         . 

.     887 

,,          with  the  actual  cautery 

758 

„          pseudo-membranous 

.     339 

Catarrhal  gastritis  in  swine   . 

190 

,,          simple  acute  . 

.     337 

„         stomatitis  in  sheep 

122 

„          verminous,     in     sheep 

and 

„                 „          general,  in 

swine  . 

126 

cattle 

.     840 

Catheter,  passage  of  the,  in  the 

cow 

750 

Broncho-pneumonia,  gangrenous,  c 

ue  to 

„                ,,           „           ,, 

ram 

749 

foreign  bo( 

ies   .     351 

Cattle,  anfemia  in  . 

268 

„                 „            infectious 

.     854 

„       bilharziosis  in      . 

439 

„                 „            of  sucking  ca 

Ives .     856 

„       diarrhoea  in 

268 

„                „           sclero-caseou 

,    of 

„       hiemorrhagic  septicemia  in 

716 

sheep 

.     3,58 

„       parasitic  gastro-enteritis  in 

268 

Bryony,  poisoning  by     . 

.     256 

,,       pseudo-membranous  pharyngitis 

Buckwheat  poisoning     . 

.     G06 

in     . 

141 

Bull,  castration  of  the    . 

.     751 

,,       verminous  bronchitis  in 

340 

Bunch-flower  family 

.     227 

Caustic  acids,  poisoning  by    . 

217 

Bursal  sheath  of  the  flexor  tend(  n 

^,  dis- 

„        alkalies,  poisoning  by 

216 

tension  of    . 

.       49 

Cerebral  congestion 

456 

Butneriacete   .... 

.     285 

„        tumours    . 

459 

Butter,  milk  without 

.     589 

Changes  in  the  milk 

587 

BnxacefB         .... 

.     240 

Chaps      ..... 
Chemical  dyspepsia 
Chenopodiacee 

568 
195 
229 

C. 

Chorioptic  mange  . 
Chronic  bronchUis 

636,  64( 

,642 
337 

Calculi  in  bovine  animals  . 

.     515 

„        cystitis 

513 

„        urinary,  in  sheep    . 

.     518 

„        diarrhoea  . 

207 

Calculus  formation 

.     514 

„        eczema 

600 

Calves,  depraved  appetite  in  . 

.     160 

„        enteritis    . 

207 

,,       diarrhoeic  enteritis  in 

.     212 

„        gastritis     . 

194 

„       dysentery  in 

.     210 

,,        glossitis  •  . 

132 

„       goitre  in      .         .         . 

.     458 

„        indigestion 

194 

,,       intestinal  coccidiosis  of 

.     271 

,,        mammitis. 

581 

,,       lumbricosis  of     . 

.     267 

,,        metritis     . 

552 

,,       mycotic  stomatitis  in 

.     124 

,,        nephritis    . 

530 

,,       necrosing  stomatitis  in 

.     128 

„        parotiditis 

136 

Calving,  dropping  after. 

.     461 

,,        pericarditis 

389 

Campanulacese 

.     255 

„        peritonitis 

481 

Cancer  of  the  bile  ducts 

.     282 

„        i)leurisy     . 

362 

11          11      liver 

.     282 

„        simple  synovitis,  forms 

of    ; 

45 

Cancerous  pericarditis    . 

.     375 

„        tympanites 

194 

Canker 

.       40 

„        vaginitis   . 

546 

„       treatment  . 

.       41 

Circulation,  organs  of  the 

370 

Capillary  system,  examination  of 

.     872 

Circulatory  apparatus    . 

727 

Carbolic  acid  poisoning . 

.     221 

Clams,  castration  by 

756 

„         dips  .... 

.     633 

Claw  and  third  phalanx,  disarticulation 

Cardiac  anomalies  . 

.     374 

of  the 

731 

Carduaceai      .... 

.     256 

„     amputation  of  the 

730 

Carrot  family 

.     247 

„     surgical  dressing  for  a  . 

730 

Caseous  lymphadenitis  of  the  shee 

p        .     453 

Claws,  congestion  of  the 

31 

Casting,  control  of  oxen  by    . 

.     723 

Clement's  bath 

623 

Castor-oil  cake,  poisoning  by 

.     257 

Clotted  milk  .... 

589 

Castration       .... 

.     751 

Coenurosis       .... 

467 

„          complications  after 

.     7()0 

Colchicum  poisoning 

256 

„          by  clams 

.     756 

Cold  water,  colic  due  to  ingestion  of 

162 

„           „   the  covered  method 

.     757 

Colic 

116 

„            „     „    elastic  ligature 

.     758 

„     as  a  result  of  strangulation  . 

167 

rNDEX. 


777 


PAGE    1 

PAGE 

Colic  due  to  invagination 

168    ! 

Digestive  apparatus        .... 

784 

„     in  the  ox  .     . 

I(i2 

,,                ,,         diseases  of     . 

106 

Common  salt,  poisoning  by    . 

217 

„                 „          fistula;  of 

500 

Complications  after  castration 

7«() 

„                „          parasites  of    . 

2ri3 

Condylomata. 

88 

,,                 ,,          semiology  of  . 

106 

Congenital  hernias . 

487 

Digestive  tract,  tuberculosis  of  the 

699 

Congestion,  pulmonary  . 

848 

Dilatation  of  the  oesophagus  . 

149 

,,           of  the  claws 

81 

„             „        oritice  of  the  teat 

770 

„                 ,,      kidneys     . 

527 

Disarticulation  of  the  claw  and  third 

„                 „       liver  ' 

280 

phalanx 

781 

„                „      udder 

570 

„                   ,,          two    fii-st    pha- 

Congestive colic 

162 

langes    . 

782 

Conjunctivitis 

662 

Diseases  of  the  bladder  .... 

511 

Contagious  disease  (takosis)  of 

goats     . 

412 

„      blood      .... 

406 

„           mammitis  in  milch 

cows     . 

580 

„           „       kidneys  .... 

527 

„           vaginitis 

545 

„           ,,       liver        .... 

279 

"  Contagious  foot  disease  "      . 

41 

„           „       lymphatic  system  . 

444 

Contraction  of  the  sphincter 

567 

„           „       mouth    .... 

106 

Control  of  pigs 

725 

„           „       cesophagus      . 

109 

„          sheep  and  goats     . 

725 

„           „       pharynx 

108 

„          oxen 

720 

„           „       salivary  glands 

108 

„             „     by  casting     . 

723 

„           „       stomach          .         .11 

3,  169 

„      general,  of  oxen 

722 

„           „       rumen    .... 

110 

Contusions  of  the  sole    . 

81 

„           „       peritoneum    and    abdo- 

ConvallariacciB 

228 

minal  cavity 

478 

Copper  poisoning    . 

221 

„           „       urinary  apparatus  . 

502 

Coryza,  gangrenous 

820 

„       produced  by  distillery  and  sugai 

„       simple 

819 

factory  pulp 

259 

Cotton  cake,  poisoning  by      . 

257 

„       transmissible  to  man  through 

Covered  method,  castration  by 

the        '. 

757 

the  medium  of  milk      . 

593 

Cow,  castration  of  the    . 

761 

Distillery     and    sugar    factory     pulp 

,,             „             ,,       complies 

tions  in 

764 

diseases  produced  by  . 

259 

„     passage  of  the  catheter  in 

the       . 

750 

Distomatosis   ..... 

293 

Cows,  epizootic  abortion  in    . 

558 

Disturbance  in  the  milk  secretion  . 

587 

Cowper's  glands     . 

597 

Dogbane  family      .... 

251 

Cow-pox          .... 

665 

Dropping  after  calving  . 

461 

„         and  human  variola  . 

669 

Dysentery  in  calves 

210 

Cracks    ..... 

568 

.,                   „       and  lambs 

271 

Creolin  bath  .... 

v<524 

Dyspepsia 

194 

Croupal  vaginitis    . 

545 

„          motor     .... 

195 

Crowfoot  family     . 

280 

„          secretory  or  chemical    . 

195 

Crushinga  foreign  bod}- in  the  cesophagus 

785 

Cryptorchids,  castration  of    . 

760 

Cysticerci,  infection  with 

73 

E. 

Cysticercosis  .... 

290 

„            peritoneal . 

485 

Echinococcosis  of  the  liver 

283 

Cysticercus  disease  of  the  pig 

78 

,,              suppurative    . 

288 

Cystic  parasites  of  animals,  table  of 

73 

Ectopia  of  the  heart       .         . 

374 

Cystitis,  acute 

511 

Eczema  ...... 

599 

„        chronic      . 

518 

„       acute         .... 

.     599 

Cysts  of  the  udder . 

585 

„       chronic     .... 
„      due   to    feeding   with    potat( 
pulp      .... 

.     600 

) 

.     608 

D. 

„       sebaceous  or  seborrhceic  . 
Elastic  ligature,  castration  by  the 

.  601 
.     758 

DEF.ECATIOX  :    examination 

of   freca 

Emphysema,  pulmonary 

.     359 

material      .... 

118 

„           subcutaneous    . 

.     659 

Demodecic  mange  . 

648 

Encephalitis 

.     458 

Depraved  appetite . 

158 

Endocarditis  .         .         .         .         • 

.     394 

„               „         in  calves  and  lambs 

160 

Enteritis 

.     203 

)•               ,,          !,  the  ox  . 

158 

„        acute        .... 

.     203 

Diaphragmatic  hernias   . 

496 

„        chronic    .... 

.     207 

Diarrhoea,  chronic  . 

.     207 

„        diarrhoeic,  in  calves 

.     212 

„          in  cattle 

268 

hajmorrhagic  . 

.     206 

„           ,,  lambs 

268 

Epizootic  abortion  in  cows     . 

.     553 

„           ,,  sheep 

268 

Equisetaceaj 

.  225 
.     223 

Diarrhoeic  enteritis  in  calves . 

212 

Ergot  family 

778 


PAGE 

Ergot  of  rye,  poisoning  by  .  .  .  223 
Ergotism  "       .         .     '   /      .         .         .228 

Ericaea; 249 

EuphorbiaceiB         .....  244 

Eventration 499 

Eversion  of  the  bladder         .         .        .  .519 

Exostoses 27 

Exposed  method,  castration  by  the  .  7.")7 
External   ischio-tibial  muscle,  rupture 

of  the 70 

Exudative   pericarditis   due  to  foreign 

bodies .......  37() 

Eyes,  diseases  of  the       ....  661 


Facial  sinuses  of  sheep,  oestrus  larvie 
in  the 
,.  ,,         trephining  the     . 

Fascal  material,  examination  of     . 
Fagaceas  ..... 

Fagopyrism     ..... 

False  sturdy 

F(UcU)la  liepatlca  .... 

Felon  " 

Female  genital  organs,  examination  of, 

with  the  speculum 
Femoro-tibial  articulation,  luxation  of 
the. 
.,  ,,  symptoms 

,,  „  treatment 

Femur,  luxation  of  .         .         . 

.,  „  „    symptoms 

,,  ,,  ,,   treatment 

Fennel,  poisoning  by      . 
Ferments,  lactic     .... 

Fern  family 

Fetlock  joint,  distension  of  the  synovial 
capsule  of  the 
„       strain  of    . 
Figwort  family       .... 
Fistula,  parotid       .... 

Fistulas,  milk 

,,       of  the  digestive  apparatus 

Flax  family 

Flexor  metatarsi,  rupture  of  the    . 
„       tendons,  distension  of  the  bursal 
sheath  of  .         .         . 

Food,  poisoning  due  to  . 
Foot,  diseases  of  the 

„     rot 

„      „     symptoms 
,,      „     treatment 

„     scab       

Foreign  bodies  causing  diseases  of  the 


exudative  pericarditis 
due  to 

gangrenous  broncho- 
pneumonia due  to 

gastric  disturbance  due 

'  to        . 

migration  of,  from  the 
reticulum,  pneumonia 
due  to 


348 


Foreign  bodies,  pneumonia  due  to 

Foreign  body  in  the  oesophagus,  crush- 
ing a 
,,  „         ,,  „     sub-mucous 

dissection 
of    . 

Fractures        ...... 

France,  bovine  piioplasmosis  in     . 

Frontal  sinus,  trejihining  the 

,.  ,,       purulent  collections  in    . 


•AGBi 
347 


736 
20 
424 
745 
327 


G. 

Gangrenous  broncho-pneumonia  due 

to  foreign  bodies         .     3.51 
„  coryza     ....     320 

„  maramitis  in  goats  .     584 

„  „         of  milch  ewes    .     588 

Gaseous  indigestion         ....     170 
Gastric  compartments,  acute  inflamma- 
tion of     .         .181) 
„  „  tumours  of  the  .     202 

,,      disturbance  due  to  foreign  bodies     198 
,,      indigestion,  acute,  in  swine        .     185 
Gastritis  ....    186,  188—194 

Gastro-intestinal  strongylosis  in  sheep  .     263 

Gastrotomy 739 

"Gathere<l  Nail" 37 

General  diseases     .....         4 

Genital  apparatus  .         .         ...         .     542 

,,  „  accessory   glands    of 

the         .         .         .597 
,,        malformations   ....     560 

,,       organs,  male      ....     594 

„  „       tuberculosis  of  the         .     700 

Genito-urinary  organs    .         .         .         .747 

„  regions   ....     5U2 

Gid 467 

Glands,  mammary,  diseases  of        .         .     565 
Glans  penis  and  sheath,  polypi  of .         .     506 

Glossitis 130 

„        acute,  deep-seated     .         .         .131 

„        chronic      .....     132 

„        nodular  sclerosing     .         .         .133 

„        superficial  .         .         .         .130 

Goat,  demodecic  mange  in  tlie       .         .     644 

,,      mange  in  tlie         .         .         .         .     (i41 

„      ringworm  in  the  ....     653 

Goats,  control  of 725 

,,      gangrenous  mammitis  in     .         .     584 
Goitre  in  calves       .....     453 

„        lambs 453 

Goosefoot  family     .....     229 

Grass  family  ......     22(! 

„     tick,  life  history  of        .         .         .     432 
Grease 41 


^MATURIA 

520 

ffimodoraceaj 

228 

temorrhagic  enteritis  .... 

206 

„                 .,            in    c.nlves    and 

lambs     . 

271 

.,             septicaemia  in  cattle 

716 

fNDEX. 


il^ 


PAGE 

PAGE 

tiffimorrhagic  septiciemia.  infective  dis 

Infectious  diseases 

.     665 

eases  confused  with     . 

.     718 

„          pj'elo-nephritis 

.     533 

Haunch,  hygroma  of       .         .         . 

.       (57 

„          pseudo-rheumatism  in  adults       99 

Heart,  ectopia  of  the      . 

.     374 

,,                  „             „          symptoms     100 

Heat  stroke 

.     442 

„                  „             „          treatment     103 

Heath  family           .... 

.     249 

„          rheumati-sm  in  young  animals       94 

Hellebore,  poisoning  by 

234 

„                   „                 „     causes 

94 

Helminthiasis,  intestinal,  in  ruminant 

,     27.5 

„                   „                 „      symptoms       95 

Hemlock,  poisoning  by  . 

248 

Infective  diseases,  confused  witii  hiemor 

Hepatitis,  nodular  necrosing . 

280 

rhagic  septicfeniia 

718 

Hernia,  inguinal,  in  young  pigs     . 

741 

Inflammation  of  the  sheath    . 

50() 

„       of  the  abomasum 

493 

.,             ,,           sub-maxillary  sali 

„             ,.;     intestine 

494 

vary  glanrl. 

137 

„             „      rumen      . 

490 

Inflammatory  diseases   . 

570 

,,        perineal,  of  young  pigs 

487 

Inguinal  hernia  in  young  pigs 

741 

Hern  ire  .         .         .         .         ."        .      48 

7,741 

Insolation        ..... 

460 

„        acijuired     .... 

489 

Interdigital  space,  inflammation  of  the 

38 

,,       congenital 

487 

Internal  infectious  phlebitis  . 

398 

„       diaphragmatic  . 

496 

Interstitial  mammitis    . 

574 

,,       treatment  of      .         .         . 

495 

Intestinal  helminthiasis  in  ruminants 

275 

Hock,  hygroma  of  the  point  of  the 

<)8 

„         tuberculosis   . 

699 

,,      joint,  distension  of  the  synovia 

Intestine 

116 

capsule  of  the 

46 

„        hernia  of  the  . 

494 

„          „      strain  of     . 

55 

Invagination,  colic  due  to 

163 

„      region,  distension  of  the  tendoi 

Inversion  and  prolapsus  of  the  rectum 

743 

sheaths  in 

46 

Iodine  poisoning     .... 

222 

Hoose      ...... 

340 

lodism    ...... 

222 

Horn  core,  trephining  the 

745 

Iodoform  poisoning 

222 

Horns,  anatomy  of          .         .         . 

21 

Ischial  urethrotomy 

747 

„      detachment  of     . 

23 

Ischio-tibial  muscle,   external,  rupture 

,,      Assuring  of          .         .         . 

24 

of  the           .         .         .         .         . 

70 

„      fractures  of         .         .         . 

21,25 

Issues 

728 

„      splints  for  .... 

26 

,,      treatment  of        .         .         . 

25 

Horse-chestnut  family    .         .         .         . 

246 

J. 

Horsetail  family 

Human  variola  and  covv-po.x 

225 

669 

Joints,  luxation  of        .        .        . 

56 

Husk 

340 

Hj^dro-nephrosis     .... 

531 

K. 

Hydro-pneumo-thorax    . 

366 

Hygroma  of  the  haunch 

67 

Keratitis 

662 

,,          ,,         knee 

65 

Kidney  worm  of  swine  . 

539 

,,          ,,         point  of  the  hock 

68 

Kidneys,  congestion  of  the     . 

527 

.,          „         point  of  the  sternum    . 

69 

„        diseases  of  the 

527 

stifle     . 

67 

Knee,  distension  of  tendon  slieaths  in 

„          „         trochanter  of  the  femui 

67 

the  region  of    . 

49 

Hygromas 

64 

„      hygroma  of . 

65 

Hypericacefe 

246 

,,      joint,  distension  of  the  synovia 

Hypocrecete 

223 

capsule  of  the  . 

47 

Hypodermosis  in  the  ox. 

646 

,,     strain  of       ...         . 

53 

Impaction  of  the  omasum    . 

,,  „  rumen 

Imperforate  anus   .... 

,,  condition  of  the  teat  . 

„  vagina 

Impetigo  in  the  pig 
Indigestion     ..... 

,,  abomasal 

acute  gastric,  in  swine 

,,  as  a  result  of  over-eating 

,,  chronic 

Infectious  broncho-pneumonia 


179 
175 
742 
567 
560 
605 
170 
182 
185 
175 
194 
354 


Lactic  ferments    .... 
Lambs,  antemia  in  .         .         . 

,,       blood  poisoning  in,  in  New  Zea 
land         .... 

,.       depraved  appetite  in 

„       diarrhoea  in        .         .         . 

„       goitre  in     . 

„       intestinal  coccidiosis  of 

,,       parasitic  gastro-enteritis  in 
Laminitis        ..... 
„         symptoms 

„         treatment 
Laparotomy 


780 


INDEX. 


Larkspur  poisoning  in  sheep  . 

Laryngitis 

,,  acute      .... 

„  pseudo-membranous 

Ijarynx  ...... 

„       examination  of 

,,       tumours  of         .         .         . 

Latliyrism 

Lead  poisoning       .... 
Licking  habit  .... 

liily  of  the  valley  family 
Lime  and  suli)liur  dips  . 

„  ,.  ]iit'jud  ice  against 

Linaceae  ..... 

Liver       

,,     cancer  of        ...         . 
„     congestion  of  .         .         . 

„  ■  diseases  of      ...         . 
,,     echinococcosis  of    . 

„     rot 

Liver-fluke  (Faaridln  /ir/i<ifii-((') 

„  disease 

Local  affections      .... 
Locomotion,  apparatus  of 

„  organs  of,  diseases  of 

„  gait  in        .        .         . 

,,  inspection  for    . 

,,  palpation  and  pressure  to 

detect    . 
,,  percussion  in 

Louping  ill     ....         . 
Lumbar   prurigo,   or   "  trembling,"    ii 

sheep  

Lumbricosis  of  calves     . 

Lund's  truss 

Lungs 

Lupines,  poisoning  by    . 
Luxation  of  the  femoro-tibial  articula 
tion  . 
„  ,,         femur  . 

„  „         ])atella 

„  „         scapulo-humeral  joint 

Lymphadenitis       .... 
liymphatic  glands,  tuberculosis  of 

„  glandular   apparatus,    topo 

graphy  of  . 
,,  system,  diseases  of 

Lympho-cythajmia 
Lymphogenic  diathesis  . 


PAGK 

281 
338 
833 
383 
333 
318 
38.-) 
243 
220 
1.58 
228 

(;27 

628 
244 
119 
282 
280 
9 
288 
298 
294 
293 
20 
730 
1 
1 
1 


63 

448 
696 

44.5 
444 
448 
448 


Magnoliace^     . 

.     229 

Magnolia  family     . 

229 

Maize,  poisoning  by  the  male  tuft 

sof 

226 

Male  genital  organs 

594 

Malformations,  genital  . 

560 

Malignant  oedema  . 

415 

Mammae,  ablation  of  the 

771 

Mammary  glands,  diseases  of 

565 

„          toxasmia 

461 

Mammitis        .... 

571 

.,          acute      .         ... 

578 

„          chronic 

581 

,,          contagious,  in  milch  co 

ws 

580 

PAGE 

Mammitis,  gangrenous  in  goats      .         .  584 

„                   ,,           of  milch  ewes      .  583 

„          interstitial     ....  574 

,,          parenchymatous    .         .         .  575 

Mange     .         .        ".         .         .         .         .611 

.,        chorioptic .         .         .      (i36,  640,  642 

,,        demodecic 643 

,,        in  the  goat         ....  641 

„             „      ox 638 

,!             „      pig 642 

„        psoroptic    .         .         .         .614,  639 
„        .sarcoptic    ....      (VdH,  641 

„        symbiotic 636 

Manual  technitiue  in  bistournage     .         .  752 

,,                 „           castration  of  the  cow  762 

„                 „                   „             ,,     sow  766 

Martelage        .         .         .         .         .         .  756 

Maxilla,  actinomycosis  of  the          .         .  678 

Maxillary  sinus,  purulent  collections  in  329 

„             „       trepliining  the      .         .  745 

Measles,  beef 79 

„         pork 78 

Mechanical  pneumonia  .         .         .         .847 
Mediastinum,    diseases     of     structures 

enclosed  within  the  .  368 

„               tuberculosis  of  the         .  697 

,,               tumours  of     .         .         .  369 

Medicated  milk 591 

Melanthaceffi 227 

Meliacese 244 

Meningitis 456 

Mercurial  poisoning        ....  219 

„          stomatitis       ....  128 
„                  „         nature  of        .         .129 

Metritis 547 

„        acute          .....  550 

„        chronic 552 

,,        septic 5.47 

Microbic  changes  in  milk        .         .         .  588 
Migration  of  foreign    boilies  from  the 

reticulum,  pneumonia  due  to      .         .  348 

Milch  cows,  contagious  miammitis  in     .  580 

„      ewes,  gangrenous  mammitis  of    .  588 

Milk,  bitter 591 

„     blue        .         .         .         .         .         .  590 

,,     changes  in  the       ....  587 

„     clotted 589 

„     diseases    transmissible    to     man 

through  the  medium  of     .        .  593 

„     fever 461 

„     fistulse 569 

,,     medicated 591 

,,     microbic  changes  in      .        .        .  588 

„     mucous,  viscous,  or  thready  .         .  589 

„     preservation  of      ...         .  591 

„     putrid 589 

„     red 590 

„     secretion,  disturbance  in  the         .  587 

„      thready 589 

,,     viscous 589 

„     without  butter      ....  589 

,,     yellow 590 

Milkweed  family 252 

Molasses  refuse,  jioisoning  by         .         .  258 

Motor  dyspepsia 195 

Mouth,  diseases  of  .         .         .        .     106,  121 

Mucous  milk 589 


781 


PAGE 

124 

70 

73 

92 

225 

12-4 

4-18 


87 
319 
311 
325 
326 
326 
675 
123 
528 
530 
537 
456 
229 
406 
399 

415 
217 
280 
133 
645 
562 


Muguet 

Muscles  and  tendons,  diseases  of 

,,        parasitic  diseases  of  . 
Muscvdar  rhenniatisiu     . 
Mushroom  family  . 
Mycotic  stomatitis  in  calves 
Myelo-cythaemia     . 


N. 


Nails,  picked-iip  . 
Nasal  cavities 

„  „        examination  of 

„  ,,        tumours  of 

„      gleet     .... 

„      sinuses,  purulent  collections 
Neck,  actinomycosis  of  the    . 
Necrosing  stomatitis  in  calves 
Nephritis,  acute 
,,  chronic . 

,,  suppurative  . 

Nervous  system 
Nettle  family 
New-born  animals,  septicajmia  of 

,,    ■  ,,      umbilical  phlebitis  of 

New  Zealand,  blood  poisoning  in  sheep 

and  lambs  in       ....         . 
Nitrates  of  potash  and  soda.'poisoning  by 
Nodular  necrosing  hepatitis  . 
,,         sclerosing  glossitis    . 
Non-psoroptic  forms  of  acariasis    . 
Nympho-mania       .         .         .         .         . 


0. 


Obstruction  of  the  abomasum    .        .     194 

CEsophageal  obstructions        .         .         .152 

„  „  treatment       .     154 

„  sounds         .         .         .         .155 

ffisophagitis 145 

(Esophagotomy       .         .         .         .156,  736 

(Esophagus 734 

,,  dilatation  of         .         .         .     149 

„  diseases  of    .         .         .      109,  145 

,,  ruptures  and  perforations  of     157 

stricture  of  .         .         .         .148 

(Estrus   larv?e  in  the  facial  sinuses  of 

sheep 330 

Oleaceaj  .......     251 

Olive  family 251 

Omasum  .         .         .         .         .         .113 

„         impaction  of  the      .         .         .179 

Omphalo-phlebitis 402 

"  Open  arthritis "    .         .         .         .         .51 

•'  Open  synovitis  " 49 

Operations      ......     720 

Ophthalmia,  verminous,  of  the  ox .         .     663 

Organs  of  circulation,  semiology  of        .     370 

„         locomotion,  diseases  of  .         .         1 

,,  ,,  „       methods 

of  examination  in        ....         1 

Orifice  of  tiie  teat,  dilatation  of  the        .     770 
Osseous  cachexia    .....         7 

„  ,,  causes  of '  .         .         .       14 

„  ,,  history  of  ,         .         .         8 


PAGE 

Osseous  cachexia,  phases  of    .         .  9 — 11 

„  „  symptoms  of      .         .8,11 

„  .,  treatment  of      .         .18 

Ostitis,  suppurating         ....       29 

Ovary,  tumours  of  the    ....     559 

Over-eating,  indigestion  as  a  result  of   .     175 
Over-exertion  ......     442 

Ovine  pasteurellosis        ....     263 

,,      piroplasmosis        ....     425 

Ox,  colic  in  the 162 

demodecic  mange  in  the  .         .     644 

depraved  appetite  in  the  .         .158 

hypodermosis  in  the         .         .  ■       .     646 

mange  in  the 638 

strongylosis  of  the  abomasi;m  in  the     268 
urethrotomy  in  the  .         .         .     747 

verminous  ophthalmia  of  the  .         .     663 
Oxen,  canker  in      .         .         .         .         .40 

„      control  of 720 

by  easting     .         .         .723 

the  limbs      .         .         .720 

„      warts  in 655 


Panaritium         .... 

41 

Pancreas          ..... 

.     119 

Papaveracese 

235 

Papillomata,  verrucous,  of  the  udder 

586 

Paralysis  of  the  bladder 

.     519 

Parasites,  cystic,  of  animals,  table  of 

73 

„         of  the  digestive  apparatus 

263 

Parasitic  diseases  of  muscles  . 

73 

,,       gastro-enteritis 

268 

„                 .,                in  cattle 

268 

„                  „                 in  lambs 

268 

,.                  ,,                 in  sheep 

268 

Parenchymatous  mammitis    . 

575 

Parotid  fistula         .... 

136 

„       glands,  actinomycosis  of  the 

675 

Parotiditis  (Parotitis)    .         .         .13 

4,136 

Parturient  apoplexy 

461 

Passage  of  the  catheter  in  the  cow 

750 

„             „             ,,             ram 

749 

Passing  the  probang 

735 

Patella,  luxation  of         .         .         . 

58 

,,               ,,             bantlage  for     . 

60 

,,               ..             sj'mptoms 

59 

,.              „             treatment 

60 

Patellar  synovial  capsule,  inflammation 

3f    45 

Pea  family 

236 

Pelvis,  fractures  of          .         .         . 

20 

Pericarditis     ..... 

375 

„          cancerous     . 

375 

„          chronic 

389 

„           exudative,   due    to    foreign 

bodies 

376 

simple  acute 

375 

,,           specific 

375 

Perineal  hernia  of  young  pigs 

487 

Perinephritis           .... 

537 

Peripneumonia  and  pneumonia,  differ- 

ences between     .... 

347 

Perisporace^           .... 

223 

Peritoneal  cysticercosis 

485 

Peritoneum,  diseases  of 

478 

782 


INDEX. 


PAGE 

PAGE 

reritonitis      .... 

478 

Poisoning 

by  bryony      . 

256 

acute     . 

478 

.,   castor-oil  cake 

257 

,,         chronic 

481 

.^ 

,,   caustic  acids     . 

217 

Persistence  of  the  urachus      . 

508 

\] 

„         ,,       alkalies 

216 

Phallaceas        .... 

225 

„ 

,,   common  salt    . 

217 

Pharyngeal  polyiii 

143 

„ 

.,   cotton  cake 

257 

Pharj'ngitis    .... 

138 

„ 

.,   ergot  of  rye 

223 

Piiarynx,  actinomycosis  of  the 

(i75 

J, 

,,   fennel 

249 

diseases  of 

.     108,  134 

„ 

.,   hellebore  . 

234 

Phlebitis         .... 

396 

„ 

,,   hemlock  . 

248 

,,         accidental 

396 

,, 

„   lupines 

241 

internal  infectious 

398 

jj 

„   male  tufts  of  maize . 

226 

umbilical 

402 

„ 

..    molasses  refuse 

258 

„          of  new-born  an i trials 

399 

„ 

„   nitrates    of    potash    ant 

„        utero-ovarian 

398 

soda       . 

217 

Phosphorus  poisoning     . 

219 

„ 

„   poppies     . 

235 

Phthiriasis      .... 

608 

., 

„   ranunculaceae  . 

234 

Physiological  anomalies 

567 

,, 

„   smut  of  barley 

224 

Phytolaccace:e 

229 

.,    8t.  John's-wort 

246 

Pica 

158 

„ 

„   sweet  sorghum  grass 

226 

Picked-up  nails 

37 

J, 

„   tartar  emetic    . 

218 

Pig,  cysticercus  disease  of  the 

73 

„ 

„   vetches     . 

243 

,1            )7            ,5            11        cause  of 

74 

" 

,,    white  loco  weed 

237 

„             „             „             „         examina- 

.,   wild  chervil 

248 

tion  foi 

77 

„ 

carbolic  acid. 

221 

„             „             „             v         symptoms 

,, 

colchicum      .         .         .      ■ 

256 

of 

75 

„ 

copper  .... 

221 

„            „            „            .,        treatment     78 

,, 

due  to  food    . 

215 

,,     demodecic  mange  in  the 

644 

,, 

iodine    .... 

222 

„     impetigo  in  the 

605 

,, 

iodoform 

222 

,,     mange  in  the  . 

642 

„ 

larkspur,  in  sheei) . 

231 

„     pneumonia  of  the    . 

710,  7U 

lead       .... 

220 

„     ringworm  in  the 

653 

„  . 

mercurial 

219 

„     urticaria  in  the 

(;56 

,, 

phosphorus    . 

219 

,,     verrucous  endocarditis  of  the 

71 

»,  713 

strychnine     . 

222 

Pigs,  control  of       .         .         . 

725 

,, 

tobacco. 

254 

„     ringing 

734 

Pokeweec 

family    .... 

229 

„     tonsilitis  in    . 

138 

Polypi  of  the  glans  penis  and  sheatli 

506 

„     young,  castration  of 

759 

„       Pt 

aryngeal 

143 

„          „       inguinal  hernia  in 

741 

Polypodiace?e          .... 

225 

,,■         .,       perineal  hernia  of 

487 

Poppies,  poisoning  by    . 

235 

Pink  family    .... 

229 

Poppy  family          .... 

235 

Piroplasmosis 

416 

Post-part 

um  paralvsis    . 

461 

Plantar  aponeurosis,  injury  to 

38 

Potato  family          .... 

252 

Plants  poisonous  to  stock 

223 

,,       pulp,    eczema    due    to    feeding 

Pleura,  diseases  of  . 

361 

with         .... 

»)03 

Pleur.-e 

343 

Preservation  of  milk 

591 

Pleurisy,  acute 

361 

Pricks  and  stabs  in  shoeing   . 

36 

„        chronic     . 

362 

l^rimrose 

family      .... 

251 

riugs       

728 

Primulaceae    ..... 

251 

Plum  family  .... 

236 

Probang, 

passing  the      . 

735 

Pneumonia  due  to  foreign  bodies 

347 

Probangs 

155 

.,      migration  of  fc 

reign 

Prolapsus  and  inversion  of  the  rectum 

743 

bodies    fron 

the 

Prostate . 

597 

reticulum 

348 

Prunace<e 

236 

„          mechanical  . 

347 

Pseudo-membranous  bronchitis 

339 

,.          mycosis  due  to  asperij 

Hi 

350 

laryngitis 

333 

of  the  pig     . 

710 

,-,                  pharyngitis    ii 

.,          simple . 

343 

cattle 

141 

Pueumo-thorax 

362 

,,                  pharyngitis  ii 

Poace<X3 

226 

slieep 

142 

Poisoning        .... 

213 

Pseudo  pericarditis         .      '  . 

390 

,,          by  acorns 

228 

Pseudo-rheumatism 

94 

,,           „   aloes 

221 

,, 

„          infectious,  in  adult 

99 

„           „   annual  meicury 

25(; 

Psoroptic 

mange     .        .        .        .61 

4,  639 

„            ,,   Araf/allus  .spicatux 

237 

Psorospei 

mosis  in  calves  and  lambs 

271 

„           „   arsenic 

218 

Pulmonai 

y  congestion   . 

343 

783 


Pulmonary  emphysema. 
Pulse,  examination  of  . 
Puncture,  in  exploration  of  the  rumen  . 

of  the  rumen 
Purulent  collections  in  the  frontal  sinus 

,,  „  ,,       maxillary 

sinus 

„  „  ,,       nasal  sinuses 

Putrid  milk 

Pyelo-nephritis,  infectious 
Pyo-pneumo-thorax        .... 


Rachitis 

„  symptoms  of 

,,  treatment  of 

Ragweed  family      .... 
Ram,  castration  of  the    . 

,,     passage  of  the  catheter  in  the 
„      urethrotomy  in  the 
Ranuiiculacefe         .         .•        .         . 

„  poisoning  by  . 

Rectal  exploration 
Rectum,  prolapsus  and  inversion  of  the 

Red  milk 

Respiratory  apparatus    .         .         .8; 
,,  ,,  examination  of 

,,  ,,  tuberculosis       c 

the  . 

Rcticuiitis 

Reticulum       ..... 
Retro-pharyngeal  glands,  tubcrculosi.s  of 
Rheumatism   ..... 
„  articular     . 

,,  infectious  forms  of     . 

,,  muscular    . 

Ring-bone       ..... 

Ringing  pigs 

Ringworm       ..... 

„  in  the  sheep,  goat,  and  pig 

Rot-mould  family  .... 

Rowels    ...... 

Rumen    ...... 

„       examination  of  the    . 
.,        hernia  of  the 
,,        impaction  of  the 
„       puncture  of  the 
Rumenitis       ..... 

Ruminants,  intestinal  helminthiasis  in 
Rupture   of   the   external    ischio-tibial 
muscle    . 
„  ,,         flexor  metatarsi 

Ruptures  and  perforations  of  the  oeso- 
phagus        ..... 


"Salivary  abscesses"  . 
Salivary  glands,  diseases  of 
Salpingitis 
Salpingo-ovaritis     . 


157 


Salt  common,  poisoning  by    . 
Sand  crack     .... 
„  symptoms     . 

treatment     . 


PAGE 

.  217 
.  34 
.  8.-. 
.       8.5 


Sarcoi)tic  scabies 612 

,,       .  mange     ....     (338,  fi41 

Saturnism 220 

Scab (ill,  614 

„     dips,  arsenical        ....  632 

„       „      carbolic          ....  683 

„       „      Clement's  bath      .         .         .  623 

„       ,,      creolin  bath  ....  624 

„        ,,      lime  and  sulphur  .         .         .  627 

.,        „      Tessier's  bath         .         .         .  622 

,,        ,,      tobacco  and  sulphur     .         .  ()2() 

„        „      Trasbot's  bath       .         .         .  (>23 

,,     foot 68() 

Scabies (ill 

„       in  sheep (ill 

Scapulo-humeral  joint,  luxation  of  the.  68 
Sclero-caseous    broncho-pneumonia    of 

sheep 8.")S 

Scleroderma (;.-)7 

Sclero.ttoma  2)i>i<li'ii'i'Ui  (kidney  worm)  .  r)8!» 

Scorbutus 104 

ScrophulariaceiB     .....  2.")") 

Scrotal  urethrotomy        ....  748 

Scurvy    ..!'....  lo4 


Sebaceous  or  seborrhoeic  eczema 
Secretory  dyspepsia        .         .         .         . 
Section  of  the  sphincter  of  the  teat 
Semiology  of  the  digestive  apparatus     . 
„  „        organs  of  circulation  . 

Septic  metritis 

Septicseniia  of  new-born  animals  . 
Serous  membranes,  tuberculosis  of 
Setons     ....... 

Sheath,  inflammation  of         .         .         . 
Sheep,  acne  in  the  .... 

.,      auEemia  in  . 

,,      bilharziosis  in      . 

„      blood  poisoning  in.  in  New  Zea- 
land .         .         . 

„      caseous  lymphadenitis  of  the 

„      catarrhal  stomatitis  in 

,,      control  of    . 

diarrhoea  in  .... 

.,      trastro-intestinal  strongylosis  in  . 

,,      larkspur  poisoning  in  .      .  . 

.,      oestrus  larvae  in  the  facial  sinuses 
of 

„      parasitic  gastro-enteritis  in 

.,      pseudo-membranous  pharyngitis 


601 
ig-f) 
770 
106 
370 
547 
406 
694 
728 
506 
606 
268 
43!) 

415 
453 
122 
725 
268 
263 
281 

880 

268 

142 
658 


ringworm  in  the 

scab 614 


scabies  in    . 

sclero  -  caseous     broncho  -  pneu 

monia  of  . 
"  trembling,"  or  luml)ar  pi 


go. 


,.      ulcerative  stomatitis  in 
,,      urinary  calculi  in 
.,       verminous  bronchitis  in 
Shoeing,  stabs  and  pricks  in 
Shoulder,  strain  of 
Simple  acute  bronchitis 


611 


475 
125 
51, S 
840 

8(! 

52 
387 


784 


PAGE 

Sinii)le  aculc  jjcricaixlitis 

.     375 

corvzii          .... 

.     31<) 

])neunioni:i 

.     343 

stomatitis    .... 

.     121 

Sinuses,  e.xami nation  of 

.     312 

Skin,  diseases  of      . 

.     5it'.) 

„      tuberculosis  of  the 

.     703 

Smut  of  bailey,  poisoning  by 

.     224 

„      family 

.     224 

SolanaceiB 

.     2r)2 

Sole,  contusions  of  the   . 

.       31 

Sow,  anatomical  arrangements  of 

the 

genital  organs  in  the 

.     7(15 

.,     castration  of  the 

.     7<;5 

„      operative  accidents  in 

.    7<;s 

Spavin  in  the  ox    . 

.       27 

Specific  pericarditis 

.     375 

Speculum,  examination  of  female  genital 

organs  with  the  .....  7()0 

Sphincter  of  the  teat,  contraction  of  the  5(i7 

„                 ,,            section  of     .         .  77(t 

Spui'ge  family         .....  244 

Stabs  and  pricks  in  shoeing   .         .         .  3(i 

Sternum,  hygroma  of  the  point  of  the    .  (lO 

Stifle,  hygroma  of  the     ....  (i7 

joint,  strain  of       ...         .  54 


225 

24(! 

24() 

223 

l()t» 

121 

122 

12(i 

128 

124 

123 

127 

125 

54 

55 

53 

52 

54 


Stink-horn  family 

St.  John's-wort  family    . 

„  poisoning  by 

Stock,  plants  poisonous  to 
Stomach,  diseases  of  the  .         .     1 

Stomatitis       ..... 
,,  catarrhal,  in  sheep 

„  general  catarrhal,  in  swine 

„  mercurial 

,,  mycotic,  in  calves 

,,  necrosing,  in  calves 

,,  ulcerative,  in  swine 

,,  in  sheep 

Strain  of  the  fetlock 
,,        „      hock  joint 
„        „      knee  .... 
.,         ,,       shoulder     . 
„        ,,      stifle  joint 

Strains  of  joints 52 

Strangulation,  colic  as  a  result  of  .  .1(57 
Strawberry-shrub  familj'  .  .  .  235 
Stricture  of  the  oesophagus  .  .  .148 
Strongylosis  of  the  abomasum  in  the  ox  2fi8 
Strychnine  poisoning      ....     222 

Sturdy 467 

Subcutaneous  connective  tissue,  diseases 

of  the            .         .         .     599 
,.            emphj'sema       .         .     (>59,  738 
Submaxillary  salivary  gland,  inflamma- 
tion of         137 

Sucking  calves,  broncho-pneumonia  of     35(5 

Sugar  factory  pulp,  diseases  produced  by     259 

Superficial  glossitis         ....     13o 

Suppurating  ostitis  ....       29 

Suppurative  echinococcosis    .         .         .     288 

„  nephritis  and  perinephritis     537 

Surgical  dressing  for  a  claw  .         .         .     730 

Suture  of  tlie  vulva         .         .         .         .     708 

„  ,,         .,       Rainard's  suture       .     7(59 

„  „         ,,       simple  suture  .     7(18 

„  „         „       Strebel's  suture        .     7(59 


PAGE 

Sweet  sorghum  grass,  poisoning  by        .     22(j 

Swine,  acute  gastric  indigestion  in         .     1S5 

„       catarrhal  gastritis  in  .         .         .190 

fever 710 

general  catarrhal  stomatitis  in  .  12() 
,,  ulcerative  stomatitis  in  .  .127 
,,      kidney  worm  of  ...     539 

Symbiotic  (chorioptic)  mange         .         .     63(> 
Synovial  capsule  of  the  hock  joint,  dis- 
tension of     .       4() 
„  ,,  „      fetlock     joint, 

distension  of      48 
„              „             „      knee  joint,  dis- 
tension of     .       47 
„        membranes,  diseases  of    .         .       45 
Synovitis 45 

T. 

Takosis 412 

Tartar  emetic,  poisoning  by  .         .         .     218 

Taxaceffi 226 

Taxus  baccata         .....     226 

Teat,  dilatation  of  the  orifice  of  the      .     770 

„     imperforate  condition  of  the  .     567 

,,     section  of  the  sphincter  of  the       .     770 

Tendon  sheaths,  distension  of  .         .       48 

„  ,,  ,,         in  the  hock 

region    .       46 
„  „  ,,         in  the  region 

of  the  knee  49 
Tendons  and  muscles,  diseases  of  .  .70 
Tessier's  scab  dip  .  .  .  .  .  (522 
Testicle,  tumours  of  the  .         .        .     594 

Tetanus 670 

Thorax,  examination  of  .        .        .815 

Thistle  family  .         .         .         .         .     256 

Third  stomach,  impaction  of  the    .         .     179 

Thready  milk 589 

Thrush 124 

Tobacco  and  sulphur  dip        .        .        .     626 
Tobacco  poisoning  ....     254 

Tongue,  actinomycosis  of  the  .  '      .     674 

Tonsilitis  in  pigs 138 

Tonsils,  diseases  of  .         .        .        .134 

Torsion,  castration  by     ....     757 

„        of  the  uterus     ....     556 

Trachea 333 

,,       examination  of  ...     314 

Tracheotomy 746 

Trasbot's  scab  dip  ....     623 

Traumatic  arthritis         ....       51 

,,  articular  synovitis         .         .       51 

lesions  .    '    .  .         .     568 

,,  synovitis        ....       49 

.,  tendinous  synovitis       .         .       50 

"  Trembling,"or  lumbar  prurigo, in  sheep     475 

Trephining  the  facial  sinuses  .         .     745 

frontal  sinus .         .         .     745 

,,  horn  core        .         .         .     744 

,,  maxillary  sinus      .         .     745 

Trichiniasis-trichinosis   ....       84 

Trochanter  of  the  femur,  hygroma  of  the       67 

Truss,  Lund's 770 

Trusses 769 

Trypanosomata,  diseases  produced  by    .     426 
Tuberculosis 682 


INDEX. 


785 


PAGE 

Tuberculosis 

acute 

704 

„ 

in  sheep,  goats,  and  pigs 

705 

» 

of  serous  membranes 

694 

,, 

,.  bones  and  articulations 

701 

„ 

.,  lymphatic  glands . 

696 

„ 

„  the  brain 

702 

„ 

„    ,,    digestive  tract 

(;99 

„ 

„    „    genital  organs 

700 

„ 

,,    „    respiratory      appa- 

ratus . 

(590 

^^ 

„    „    skin 

703 

Tuberculous 

septicsemia 

704 

Tumours, 

bone        .... 

30 

„ 

06 

•ebral  .... 

4.59 

of  the  gastric  compartments 

202 

,, 

.,     larynx . 

335 

j, 

,,      mediastinum 

369 

„ 

„      nasal  cavities 

325 

.J 

„     ovary   . 

559 

,,     testicle 

594 

„     udder   . 

5S5 

„     uterus  . 

5.59 

Turn-sick 

467 

Tympani 

es. 

chronic 

194 

u. 


Uddek,  congestion  of  the 
,,        cysts  of  the 
,.        tuberculosis  of  the    . 

tumours  of  the . 
.,        verrucous  papilloftiata  of  the 
Ulcerative  gastritis 

,,  stomatitis  in  sheep 

,,  ,,  swine 

Umbilical  phlebitis 

,,  ,,        of  new-born  animals 

Umbrella-tree  family 
Urachus,  persistence  of  the    . 
Urethrotomy  in  the  ox  . 
,,  ,.        ram 

Urinary  apparatus,  diseases  of  the 
„        calculi  in  sheep 

lithiasis  .... 


570 
585 
701 
585 
586 
191 
125 
127 
402 
399 
244 
508 
747 
749 
502 
518 
514 


PAGE 

Urticaceas       .... 

.     229 

Urticaria  in  the  pig 

.     656 

UstilaginaccEe 

.     224 

Utero-ovarian  phlebitis  . 

.     398 

Uterus,  torsion  of  the     . 

.     556 

.,       tumours  of  the  . 

.     559 

Vaccine,  preparation  of 

669 

Vaccinia 

665 

Vagina,  imperforate 

5<)0 

Vaginitis 

.-.43 

.,         acute 

544 

,,         chronic   . 

546 

.,         contagious 

545 

,,         croupal  . 

.545 

Veins,  examination  of 

372 

Verminous  bronchitis  in 

sheep  and  cattle 

340 

,,          conjunctivitis 

•662 

„          ophthalmia  of  the  ox     . 

6(i3 

Verrucous  endocarditis  of  the  pig  .      710 

713 

Verrucous  papiiloraata  of  the  udder 

586 

Vesiculfe  seminales         .... 

.597 

Vetches,  poisoning  hy 

243 

ViciaceiB 

23(5 

Viscous  milk  . 

589 

Vulva,  suture  of  the 

768 

w. 


AVarbles       .... 
Warts  in  oxen 

Whitlow 

White  loco  weed,  poisoning  l)y 
Wild  chervil,  poisoning  by     . 
Wounds  or  trarimatic  lesions 


41 
237 

248 
568 


Yellow  milk 

Yew  family     . 

,,     poisoning 


590 
226 
226 


D.C. 


3e 


BEADBURV,     AGNEW 


CO.LD.,    PRl> 


BRS,    LONDON 


TON  BRIDGE. 


"^^        N.  MANCHESTER- 

Indiana  46962_ 


^-^    Vtt 


cAN>y 


DEC  0  7  ZOOO 
MAR  2  6  2001 
MAR  2  4  2002 
AUG  I  9  2002 
AUG  2  1  2002 

OCT  14  2003 


